title: The association between alcohol and tobacco use among elementary and high school students in Crete, Greece.
abstract: BACKGROUND
  Tobacco and alcohol use during adolescence have potential long term health consequences and a possibility of future addiction.
  
  
  METHODS
  This cross sectional study took place in 2007 among a convenience sample of 981 adolescents from public elementary and high schools in Eastern Crete, Greece. Following parental consent, an anonymous structured questionnaire including information on personal and family use of alcohol and tobacco was distributed.
  
  
  RESULTS
  Among the entire study population, cigarette experimentation was found to be associated with current alcohol use, with an Adjusted Odds Ratio (aOR) of 38.8; (95%C.I: 5.33-58.2) and with having a smoker in the immediate family (aOR 10.3; 95%C.I: 3.14-34.0). Among the subset of elementary school children, cigarette smoking was strongly associated with current alcohol use aOR 9.7; (95%C.I: 2.12-44.3), while the association between smoking experimentation and sibling and parental alcohol use was statistically significant within the entire population (however not among elementary students) with an aOR of 2.76 (95%C.I: 1.24-6.15) and aOR 3.66, (95%C.I: 1.97-6.81) respectively. The elementary child's gender was not found to be associated with cigarette experimentation among this study population.
  
  
  CONCLUSIONS
  Strong associations were found between alcohol use and tobacco experimentation. The potential parental influence on consequent adolescent tobacco and alcohol use was also noted. Potential community based interventions, if launched in Greece, should take the role of the Greek family into account.
authors.affiliation: Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, P,O 71003, Greece. vardavas@edu.med.uoc.gr.
authors.forename: Ioanna G
authors.initials: IG
authors.lastname: Tsiligianni
authors.forename: Constantine Ilias
authors.initials: CI
authors.lastname: Vardavas
authors.forename: Izolde
authors.initials: I
authors.lastname: Bouloukaki
authors.forename: Epameinondas
authors.initials: E
authors.lastname: Kosmas
authors.forename: Evgenia
authors.initials: E
authors.lastname: Verigou
authors.forename: Maria
authors.initials: M
authors.lastname: Kiriakaki
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Siafakas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tzanakis