[Poor school performance associated with tobacco persistence among Mexican students].
OBJECTIVE
To evaluate the independent effect of poor school performance and tobacco persistence using a prospective population study of students who remained on school grounds during the follow-up period. Two measurements were taken over a period of three years.


METHODS
A cohort study conducted within school confines was developed over the period 1998 to 1999 and 2000 to 2001, with 2,568 students, including both tobacco persistent students and non-consumers. Multiple logistic regression models were designed and structured according to educational performance using two standards: students who maintained and/or improved performance and those with poor performance, based on the first and second measurements.


RESULTS
In the reference cohort, 5.2% of the students reported to have persisted with tobacco consumption during the study period, while 64.2% remained unexposed. Poor school performance was associated with tobacco persistence for the total population (OR 2.27, 95%CI 1.4-3.6), as well as for females (OR 3.0 95%CI 1.4-6.7) and males (OR 2.2 95%CI 1.1-4.1). Poor school performance has an excess risk of tobacco persistence, independently of other co-variables. The greatest difference in prevalence, using poor school performance as a reference, was observed in those subjects having depressive symptomolgy, with an excessive tobacco persistence of 21.3%.


CONCLUSIONS
Interventions that foster healthy lifestyles within school environments should be adopted in a comprehensive manner. In addition, students who perform poorly should be considered vulnerable to unhealthy lifestyles. It will therefore be necessary to identify them as high risk subjects and implement interventions among this population, particularly with regard to combatting addictions.
Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Rafael
R
Anaya-Ocampo
Edna
E
Arillo-Santillán
Luisa María
LM
Sánchez-Zamorano
Eduardo
E
Lazcano-Ponce
D000124:Achievement; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008800:Mexico; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D013334:Students / Q000523:psychology; D013997:Time Factors