The brightest students smoke less, Spanish study finds

To what degree do certain factors, such as academic performance, the level of studies completed by the parents, enrollment in a public or private school, or parental permission to smoke or not, increase the probability that teenagers will smoke? These are some of the questions that scientists at UC3M have attempted to answer through a line of research carried out in collaboration with the Servicio de Epidemiología (Epidemiology Service) of the Autonomous Community of Madrid, the Carlos III Institute of Health and the Universidad Autónoma of Madrid.

The researchers have discovered a close relationship between academic performance and the habit of smoking: the lower the level of the first factor, the higher the incidence of the second. "We have found that the use of tobacco is three or four times higher among those students whose academic performance is of a low level as compared to those who earn the highest grades," explains one of the authors of the study, María Durbán, of UC3M's Statistics Department. The study also points out the importance of the parents' tolerance, since among students who report that they do not have parental permission to smoke the probability that they will do so is cut nearly in half.

The researchers do not consider that whether the school is public or private or the level of education reached by the parents constitute factors that increase the probability of students smoking. However, the researchers do highlight the importance of the family environment due to its direct influence on the development of teenagers' habits. "Thus, the incidence of teen smoking is greater in those homes where another family member is a smoker," point out the scientists, who have published some of the study's findings in the journal Nicotine & Tobacco Research.

The context of smoking

This research is part of a broader study that analyzes the individual and contextual factors associated with tobacco use in public high schools (Institutos de Educación Secundaria -- IES). Another paper published by the researchers in the journal Prevention Science concludes that smoking bans and prevention policies in high schools (IES) contribute to significantly reducing students' risk of becoming smokers, regardless of an individual adolescent's personal characteristics. "Some educational centers are more effective than others because they assign more resources to this area," according to the researchers. For example, there are more teachers monitoring during recess, greater control of the school entrances and exits and a greater number of activities devoted to prevention, such as talks, seminars, etc. "Those schools with better prevention policies have a lesser probability that their students who smoke will do so on the school premises," they conclude.

To carry out these studies, the researchers gathered information by using a questionnaire sent to a representative sampling of students in 4th year of ESO (the equivalent of high school sophomores -approximately 16 years old) in the Autonomous Community of Madrid (9127 students in 203 schools). In addition, they interviewed the principals of approximately 100 educational centers to collect information regarding the centers' policies. The analysis of those data was based on multilevel regression models, which allowed them to combine information obtained at different levels of aggregation (at the individual level and at the school level).

Up until now, attempts to prevent smoking by students had mainly centered on carrying out health education activities directed at them. These new studies, however, broaden the focus to more contextual aspects, such as the development of prevention policies in the schools or the evaluation of the effect of regulations that limit tobacco sales, use and advertising. Moreover, these researchers are also analyzing other important subjects related to student health, such as the effect of recommendations regarding physical activity and a healthy diet.

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