Smoking among Dutch elementary schoolchildren: gender-specific predictors.
Higher rates of smoking initiation and continuation by female compared with male adolescents, as found in many developed countries, may call for gender-specific prevention programs. Risk factors of smoking initiation and continuation were examined prospectively (1997-2002) among 3205 Dutch elementary schoolchildren (mean age 11.64) in an intervention trial using written questionnaires and multilevel logistic regression. At baseline, smoking prevalence was lower among girls than among boys; at follow-up, smoking initiation was lower among girls than among boys. Concerning smoking initiation, girls and boys shared the following risk factors: age, modeling from parents and siblings ('modeling nuclear'), modeling from other members in the social circle ('modeling diffuse') and perceived pro-tobacco pressure to smoke. The only gender-specific predictor of smoking initiation was parent origin; girls with non-Dutch parents could be targeted for prevention programs. Concerning continuation, girls and boys shared the following risk factors: older age, more modeling nuclear and diffuse, fewer smoking disadvantages and lower self-efficacy to refrain from smoking. This study confirms that social modeling, smoking attitude and self-efficacy information to refrain from smoking deserve a prominent place in smoking prevention programs for schoolchildren. Besides booster sessions, family-directed programs are suggested. No gender-specific predictors of later smoking initiation were found, apart from parent origin, which is not amenable to intervention.
Ausems
M
M
The Maastricht Health Research Institute for Prevention and Care (CAPHRI), Department of Health Education and Promotion, Faculty of Health Medicine and Life Sciences, The Netherlands.
Mesters
I
I
van Breukelen
G
G
De Vries
H
H
D000293:Adolescent; D000294:Adolescent Behavior; D017668:Age of Onset; D002648:Child; D002652:Child Behavior; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*