title: A multi-level analysis examining how smoking friends, parents, and older students in the school environment are risk factors for susceptibility to smoking among non-smoking elementary school youth.
abstract: The purpose of this study was to examine how social models for smoking are related to smoking susceptibility among a sample of non-smoking elementary school students. The Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) was administered to 6,431 students (grades 6 to 8) in 57 elementary schools in the province of Ontario, Canada. Multi-level logistic regression analysis was used to examine how smoking friends, parents, and the prevalence of smoking among grade 8 students at a school were related to smoking susceptibility among the 2,478 non-smoking grade 6 and 7 students. Findings indicate that non-smoking grade 6 and 7 students are more likely to be susceptible to smoking if they have (a) smoking friends, (b) a mother who smokes, or (c) two or more close friends who smoke and attend a school with a relatively high smoking rate among the grade 8 students. Sub-populations of non-smoking youth may be at increased risk for smoking because of the elementary school they attend. Future school-based smoking prevention programs might benefit from targeting prevention programming activities to the schools that are putting students at the greatest risk for smoking.
authors.affiliation: Division of Preventive Oncology, Cancer Care Ontario, Toronto, ON, Canada, M5G 2L7. scott.leatherdale@cancercare.on.ca
authors.forename: Scott T
authors.initials: ST
authors.lastname: Leatherdale
authors.forename: Paul W
authors.initials: PW
authors.lastname: McDonald
authors.forename: Roy
authors.initials: R
authors.lastname: Cameron
authors.forename: Mari Alice
authors.initials: MA
authors.lastname: Jolin
authors.forename: K Stephen
authors.initials: KS
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010379:Peer Group; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012574:Schools; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D000074606:Smoking Prevention; D012931:Social Environment; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data