title: Are experimental smokers different from their never-smoking classmates? A multilevel analysis of Canadian youth in grades 9 to 12.
abstract: BACKGROUND
  Understanding the characteristics of experimental smoking among youth is critical for designing prevention programs. This study examined which student- and school-level factors differentiated experimental smokers from never smokers in a nationally representative sample of Canadian students in grades 9 to 12.
  
  
  METHODS
  School-level data from the 2006 Canadian Census and one built environment characteristic (tobacco retailer density) were linked with data from secondary school students from the 2008-2009 Canadian Youth Smoking Survey and examined using multilevel logistic regression analyses.
  
  
  RESULTS
  Experimental smoking rates varied across schools (p < .001). The location (adjusted odds ratio [AOR] = 0.66, 95% CI: 0.49-0.89) of the school (urban vs. rural) was associated with the odds of a student being an experimental smoker versus a never smoker when adjusting for student characteristics. Students were more likely to be experimental smokers if they were in a lower grade, reported low school connectedness, used alcohol or marijuana, believed that smoking can help people relax, received pocket money each week and had a family member or close friend who smoked cigarettes.
  
  
  CONCLUSIONS
  School-based tobacco prevention programs need to be grade-sensitive and comprehensive in scope; include strategies that can increase students' attachment to their school; and address multi-substance use, tobacco-related beliefs and the use of pocket money. These programs should also reach out to students who have smoking friends and family members. Schools located in rural settings may require additional resources.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: S C
authors.initials: SC
authors.lastname: Kaai
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: S R
authors.initials: SR
authors.lastname: Manske
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: S T
authors.initials: ST
authors.lastname: Leatherdale
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, Canada; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: K S
authors.initials: KS
authors.lastname: Brown
authors.affiliation: School of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Murnaghan
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D003132:Commerce / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004779:Environment Design; D005260:Female; D033062:Friends; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D009679:Nuclear Family; D016134:Organizational Policy; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012574:Schools / Q000458:organization & administration; D012907:Smoking / Q000453:epidemiology* / Q000331:legislation & jurisprudence / Q000523:psychology*; D012931:Social Environment; D062789:Tobacco Products / Q000191:economics / Q000600:supply & distribution*; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Canada; multilevel analysis; prevention; tobacco smoking; youth