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Am J Epidemiol 2004; 159:127-132.
Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Prospective Study of the Effect of Exposure to Other Smokers in High School Tutor Groups on the Risk of Incident Smoking in Adolescence

Andrew Molyneux1 , Sarah Lewis1, Marilyn Antoniak1, William Browne2, Ann McNeill3, Christine Godfrey4, Richard Madeley5 and John Britton6

1 Division of Respiratory Medicine, University of Nottingham, City Hospital, Nottingham, United Kingdom.
2 Division of Mathematical Sciences, University of Nottingham, University Park, Nottingham, United Kingdom.
3 Freelance consultant, Beckenham, Kent, United Kingdom.
4 Centre for Health Economics, University of York, York, United Kingdom.
5 Division of Epidemiology and Public Health, University of Nottingham, University Hospital, Nottingham, United Kingdom.
6 Division of Epidemiology and Public Health, University of Nottingham, City Hospital, Nottingham, United Kingdom.

Adolescent smokers tend to have peers who smoke, but it is unclear whether this arises from self-selection of smoking peers or whether this is a causal effect on the uptake of smoking (incident smoking). The authors used school tutor group current smoking prevalence, an unbiased measure of peer smoking in high schools in the United Kingdom, to estimate the independent effect of peer smoking on incident smoking among high school students. In a prospective cohort study of children aged 13–15 years (grades 9 and 10) in 10 high schools in Nottinghamshire, United Kingdom, smoking behavior was surveyed in 2,881 students in 2000, and the survey was repeated in 2,109 students (73%) in 2001. There were 267 incident smokers (15%) among the 1,766 nonsmokers in 2000. The adjusted odds of incident smoking were significantly higher in girls, in students with parents or siblings who smoke, and in relation to school tutor group current smoking prevalence in 2000 (relative odds for highest relative to the lowest quartile of prevalence = 1.78, 95% confidence interval: 1.20, 2.64). This tutor group effect was independent of having a best friend who smoked in the 2001 study. Incident smoking is therefore increased among students exposed to other students who smoke, and preventing smoking at school may reduce adolescent smoking.

adolescent; incidence; schools; smoking; students

Abbreviations: Abbreviation: MIMAS, Manchester Information and Associated Services.


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