title: The influence of friends, family, and older peers on smoking among elementary school students: low-risk students in high-risk schools.
abstract: BACKGROUND
  This study examined how older smoking peers at school and the smoking behaviour of friends and family members are related to youth smoking.
  
  
  METHODS
  Multi-level logistic regression analysis was used to examine correlates of ever smoking in a sample of 4286 grade 6 and 7 students from 57 elementary schools in Ontario, Canada (2001).
  
  
  RESULTS
  Each 1% increase in the smoking rate among grade 8 students increased the odds that a student in grades 6 or 7 was an ever smoker versus never smoker [OR 1.05, 95% CI 1.02 to 1.08]. A low-risk student (no family or friends who smoke) was almost three times more likely to try smoking if he/she attended an elementary school with a relatively high prevalence of senior students who smoke than if he/she attended a school with a low prevalence of senior students who smoke.
  
  
  CONCLUSIONS
  Low-risk grade 6 and 7 students are at significantly greater risk of smoking if they attend an elementary school with a relatively high prevalence of smoking among senior students. Prevention programs should target both at-risk schools and at-risk students.
authors.affiliation: Division of Preventive Oncology, Cancer Care Ontario, Toronto, Canada. scott.leatherdale@cancercare.on.ca
authors.forename: Scott T
authors.initials: ST
authors.lastname: Leatherdale
authors.forename: Roy
authors.initials: R
authors.lastname: Cameron
authors.forename: K Stephen
authors.initials: KS
authors.lastname: Brown
authors.forename: Mari Alice
authors.initials: MA
authors.lastname: Jolin
authors.forename: Christina
authors.initials: C
authors.lastname: Kroeker
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009864:Ontario / Q000453:epidemiology; D010379:Peer Group; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation; D012931:Social Environment; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data