title: Susceptibility to cigarette smoking among secondary and high school students from a socially disadvantaged rural area in Poland.
abstract: BACKGROUND
  To prevent adolescents from becoming smokers, it is essential to understand factors that cause them to become susceptible to smoking (SS). The aim of this study was to examine association between individual and school characteristics and susceptibility to smoking initiation and experimentation in the youth.
  
  
  METHODS
  We collected cross-sectional survey data from students aged 13-19 years attending 21 schools from Piotrkowski district. Of 4050 students, 3552 respondents, including 2508 non-smokers, filled in an anonymous, self-administered questionnaire adapted from the Global Youth Tobacco Survey. The univariate and multivariate logistic regression analyses were applied to the study factors linked to SS among the never and ever smoking youth.
  
  
  RESULTS
  About 22 % of the never smoking and 57 % of the ever smoking students were found to be vulnerable to smoking. The youth who were males (OR = 1.4; p = 0.001), who were older (OR = 1.1; p = 0.002) and those, whose mothers had medium (OR = 1.8; p < 0.001) and lower (OR = 4.1; p < 0.001) educational levels were more prone regarding future smoking compared to the females, younger ones and those whose mothers were highly educated. The students who lived in households with no smoking ban (OR = 1.4; p = 0.001) and those who had ever tried cigarettes (OR = 3.5; p < 0.001) were more susceptible to smoking comparing to those who indicated smoke-free home and who had never smoked. In addition, having smoking friends (OR = 2.3; p < 0.001), seeing school personnel smoking on the premises of the school (OR = 1.8; p < 0.001) and perceiving smoking girls more attractive than the non-smokers (OR = 3.8; p < 0.001) were the correlates of smoking susceptibility. Finally, the separate analysis among the never smokers indicated that no school training on tobacco harm (OR = 1.3; p = 0.04) is the additional significant factor for susceptibility to smoking initiation.
  
  
  CONCLUSIONS
  SS is prevalent in secondary and high school students in Poland. Personal, social and environmental factors are strongly correlated with SS. When addressing the youth, efforts should be focused on the groups at risk, with a comprehensive approach including multiple factors and involving school personnel, parents and the group leaders in tobacco control activities. Projects aimed at changing social norms around smoking and providing the youth with knowledge and skills to resist smoking are also needed. This may help to implement an effective approach to prevent smoking susceptibility and initiation of tobacco use among the youth.
authors.affiliation: Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, Zeligowskiego 7/8 Street, 90-752 Lodz, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Polańska
authors.affiliation: Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, Zeligowskiego 7/8 Street, 90-752 Lodz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Wojtysiak
authors.affiliation: Department of Nutrition in Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland.
authors.forename: Leokadia
authors.initials: L
authors.lastname: Bąk-Romaniszyn
authors.affiliation: Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, Zeligowskiego 7/8 Street, 90-752 Lodz, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Kaleta
keywords: Adolescents; Poland; Socially disadvantaged rural area; Students; Susceptibility to smoking