vesa saaristo nhprc2013
DESCRIPTION
School systematic tobacco use documenting, pupils’ smoking and perceptions of school smoking policyTRANSCRIPT
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 1
School systematic tobacco use documenting, pupils’ smoking and
perceptions of school smoking policyVesa Saaristo, Jenni Kulmala, Susanna Raisamo, Arja Rimpelä, Timo Ståhl
The 7th Nordic Health Promotion Research Conference
Vestfold University College, Horten, Norway
17.6.2013
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 2
Objective
• Studies report contradictory results of the effectiveness of school smoking policies in adolescent smoking prevention.
• We studied whether the enforcement of a tobacco use documenting policy at school is associated with– pupils’ perceptions of school smoking policy and– their smoking behaviour
17.6.2013
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 3
Datasets
• Two nationally representative cross-sectional datasets– TEAviisari (http://www.thl.fi/teaviisari)
• a national database on health promotion capacity building• data collected from Finnish comprehensive school administrations in
autumn 2009
– School Health Promotion Study• school based pupil survey for 14-15 year olds• collected in spring 2009 and spring 2010 covering the whole country• pupils reported their perceptions of school’s smoking policy and their
smoking behaviour during the school day
– For this study we restricted the data to schools where smoking had been detected (n=496; 74,143 pupils)
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Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 4
Method
• Mixed effects logistic regression– R function glmer (package lme4, Bates et al. 2012)– Binary outcome variables– Logit link function– Ordinal school-level predictor
• Documenting policy for smoking
– Dichotomous pupil-level predictors• Smoking status (Daily/No)• Gender (Boy/Girl)• Grade (8th/9th)• Parents’ education
– Random intercept for each school
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Results
• The prevalence of daily smoking was 15 %.
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Never smoked/
Only one cigarette
%
Quit
%
Less than weekly
%
Weekly
%
Daily
%
Total
% N
Boys8th 61 15 7 4 14 100 18,660
9th 52 15 8 5 20 100 18,703
Girls8th 64 13 8 4 10 100 18,912
9th 53 14 12 6 16 100 18,784
TOTAL 57 14 9 5 15 100 75,059
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 6
Results
17.6.2013
Never smoked/ Only one cigarette
%Quit
%
Less than
weekly%
Weekly%
Daily%
Total
% N
Don’t know (3) 70 11 9 5 6 100 112
Smoking did not exist (32) 60 15 11 5 10 100 804
Existed, detected cases were not documented (54) 58 14 8 4 15 100 7,219
Existed and detected cases were documented (417) 57 14 9 5 15 100 62,553
Existed, detected cases were documented and
school-specific summaries were conducted (25)
58 14 9 5 14 100 4,371
TOTAL 57 14 9 5 15 100 75,059
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 7
Results
17.6.2013
Never smoked/ Only one cigarette
%Quit
%
Less than
weekly%
Weekly%
Daily%
Total
% N
Don’t know 70 11 9 5 6 100 112
Smoking did not exist 60 15 11 5 10 100 804
Existed, detected cases were not documented (54) 58 14 8 4 15 100 7,219
Existed and detected cases were documented (417) 57 14 9 5 15 100 62,553
Existed, detected cases were documented and
school-specific summaries were conducted (25)
58 14 9 5 14 100 4,371
TOTAL 57 14 9 5 15 100 75,059
p=0.17
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 8
”Smoking restrictions are monitored at school”
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Neither
At least one parent (ref.)
PARENT HAS A HIGHER EDUCATION DEGREE
9th
8th (ref.)
GRADE
Girl
Boy (ref.)
GENDER
Yes
No (ref.)
PUPIL SMOKES DAILY
Documented and summarised
Documented
No (ref.)
SMOKING DOCUMENTED BY SCHOOL
0.10 1.00 10.00ODDS RATIO
OR 1,88
OR 1,6772 %
81 %
84 %
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 9
“Smoking is totally prohibited at school”
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Neither
At least one parent (ref.)
PARENT HAS A HIGHER EDUCATION DEGREE
9th
8th (ref.)
GRADE
Girl
Boy (ref.)
GENDER
Yes
No (ref.)
PUPIL SMOKES DAILY
Documented and summarised
Documented
No (ref.)
SMOKING DOCUMENTED BY SCHOOL
0.10 1.00 10.00
OR 2,43
OR 2,35
ODDS RATIO
83 %
92 %
92 %
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 10
Neither
At least one parent (ref.)
PARENT HAS A HIGHER EDUCATION DEGREE
9th
8th (ref.)
GRADE
Girl
Boy (ref.)
GENDER
Yes
No (ref.)
PUPIL SMOKES DAILY
Documented and summarised
Documented
No (ref.)
SMOKING DOCUMENTED BY SCHOOL
0.1 1 10
OR 1,82
A pupil who smokes at least weekly (n=14,523) never smokes at the vicinity of the school
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ODDS RATIO
19 %
28 %
26 %
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Neither
At least one parent (ref.)
PARENT HAS A HIGHER EDUCATION DEGREE
9th
8th (ref.)
GRADE
Girl
Boy (ref.)
GENDER
Yes
No (ref.)
PUPIL SMOKES DAILY
Documented and summarised
Documented
No (ref.)
SMOKING DOCUMENTED BY SCHOOL
0.1 1 10
A pupil who smokes at least weekly (n=14,523) never smokes at school, in school area
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ODDS RATIO
39 %
40 %
44 %
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 12
Neither
At least one parent (ref.)
PARENT HAS A HIGHER EDUCATION DEGREE
9th
8th (ref.)
GRADE
Girl
Boy (ref.)
GENDER
Yes
No (ref.)
PUPIL SMOKES DAILY
Documented and summarised
Documented
No (ref.)
SMOKING DOCUMENTED BY SCHOOL
0.1 1
A pupil who smokes at least weekly (n=14,523) never smokes on the way to/from school
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ODDS RATIO
17 %
16 %
17 %
Saaristo, Kulmala, Raisamo, Rimpelä, Ståhl 13
Conclusions
• Documenting detected tobacco use during the school day was associated with– pupils’ perceptions of school’s smoking policy– their smoking at the vicinity of the school
• but not their– smoking on school premises– smoking on the way to or from school– overall smoking status
• A simple and fairly inexpensive documenting policy could be an effective tool for reducing pupils’ smoking during the school day.
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