Link between perceived smoking behaviour at school and students smoking status: a large survey among Italian adolescents

review
- There is an association between perception of smoking and smoking status.
- Perception of employees or pupils smoking at school was higher among smoker.
- Smokers were less aware of preventive intervention organized at school.
- Knowledge about health effects of smoking differed between smokers and non-smokers.
- The article may serve as a basis for more tailored school-based interventions.

ObjectivesTo investigate a possible link between sociodemographic factors, the perception of smoking habits at school and smoking status of Italian adolescents attending secondary school.Study designThe study was a cross-sectional study.MethodsAn anonymous online survey was employed to gather information on age, gender, smoking status and to examine the perception of smoking behaviour on the school premises. Chi-squared and Kruskal-Wallis tests were performed for the univariate analysis and logistic and multinomial regressions for the multivariate analysis.ResultsThe statistical analyses included 1889 students. Univariate analysis showed significant differences concerning knowledge between smoker and non-smoker concerning the harmfulness of smoking (P < 0.001). According to the multivariate analysis smokers had a higher perception of teacher, principal or janitor smoking at school (odds ratio: 1.54 [95% confidence interval 1.26-1.89]). Students older than 19 years most often begin smoking because their friends smoke compared with younger students (adjusted odds ratio: 1.18 [95% confidence interval 0.48-2.89]).ConclusionSchool environment and behaviour of role models play a crucial part in student smoking. To prevent and reduce youth tobacco smoking, not merely the presence of preventive measures is important but greater attention needs to be placed on the enforcement of smoking policies.