title: School and community predictors of smoking: a longitudinal study of Canadian high schools.
abstract: OBJECTIVE
  We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time.
  
  
  METHODS
  We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence.
  
  
  RESULTS
  Between 2004 and 2007, smoking prevalence decreased from 13.3% to 10.7% in cohort schools. Predictors of lower school smoking prevalence included both school characteristics related to prevention programming and community characteristics, including higher cigarette prices, a greater proportion of immigrants, higher education levels, and lower median household income.
  
  
  CONCLUSIONS
  Effective approaches to reduce adolescent smoking will require interventions that focus on multiple factors. In particular, prevention programming and high pricing for cigarettes sold near schools may contribute to lower school smoking rates, and these factors are amenable to change. A sustained focus on smoking prevention is needed to maintain low levels of adolescent smoking.
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. clovato@ubc.ca
authors.forename: Chris
authors.initials: C
authors.lastname: Lovato
authors.forename: Allison
authors.initials: A
authors.lastname: Watts
authors.forename: K Stephen
authors.initials: KS
authors.lastname: Brown
authors.forename: Derrick
authors.initials: D
authors.lastname: Lee
authors.forename: Catherine
authors.initials: C
authors.lastname: Sabiston
authors.forename: Candace
authors.initials: C
authors.lastname: Nykiforuk
authors.forename: John
authors.initials: J
authors.lastname: Eyles
authors.forename: Steve
authors.initials: S
authors.lastname: Manske
authors.forename: H Sharon
authors.initials: HS
authors.lastname: Campbell
authors.forename: Mary
authors.initials: M
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D015331:Cohort Studies; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D007182:Income; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012574:Schools / Q000706:statistics & numerical data* / Q000639:trends; D012907:Smoking / Q000453:epidemiology* / Q000639:trends; D000074606:Smoking Prevention; D062789:Tobacco Products / Q000191:economics; D055815:Young Adult