Abstract
Objective
Studies in other countries have shown that school tobacco control policy has potential to prevent smoking uptake in adolescents. Since no Canadian research has studied this association, we assessed the statistical link between school tobacco policy and smoking status in Ontario elementary and secondary schools.
Methods
We conducted secondary analysis of data collected using the School Smoking Profile, a cross-sectional, self-report questionnaire. School policy variables were formed from five survey items concerning students’ perceptions of school tobacco control policy. Smoking status was determined through self-report measures which had been validated by carbon monoxide testing. Logistic regression models used school policy variables to explain smoking status in elementary and secondary schools, controlling for school location, school size, and student’s grade level.
Results
The smoking policy variables, rules and enforcement, explained smoking status after controlling for other variables. In elementary schools, perceptions of stronger enforcement reduced the odds of being a smoker (OR=0.39, CI99=0.34-0.44). In secondary schools, enforcement lost its protective effect (OR=1.05, CI99=1.00-1.10). In addition, student perceptions that rules were strong were indicative of increased smoking in secondary schools (OR=1.32, CI99=1.27-1.37).
Discussion
Strong enforcement of school tobacco control policy appears to be effective in elementary schools but is not as helpful in secondary schools. Secondary school policymakers should consider modifying their sanctions to avoid alienating smokers. Supported by: Ontario Tobacco Research Unit through a Graduate Studentship for Research in Tobacco Control, Social Sciences & Humanities Research Council Grant #828-1999-1019 and the Sociobehavioural Cancer Research Network (SCRN). The SCRN is operated by the Canadian Cancer Society and National Cancer Institute of Canada’s Centre for Behavioural Research and Program Evaluation.
Résumé
Objectif
Des études menées dans d’autres pays ont montré que les politiques de lutte contre le tabagisme à l’école peuvent parfois empêcher les adolescents de commencer à fumer. Comme aucune étude canadienne n’a encore porté sur cette association, nous avons évalué le lien statistique entre les politiques scolaires de lutte contre le tabagisme et l’usage du tabac dans les écoles primaires et secondaires de l’Ontario. Méthode: Nous avons procédé à l’analyse secondaire de données recueillies à l’aide du School Smoking Profile, un questionnaire transversal d’auto-évaluation du tabagisme dans les écoles. Les variables des politiques scolaires ont été déterminées à partir des cinq éléments du questionnaire portant sur la perception, par les élèves, des politiques de lutte contre le tabagisme à l’école. L’usage du tabac a été déterminé au moyen de mesures d’autodéclaration validées par un test de dépistage du monoxyde de carbone. Des modèles de régression logistique fondés sur les variables des politiques scolaires ont servi à expliquer l’usage du tabac dans les écoles primaires et secondaires, en tenant compte de l’emplacement de l’école, de sa taille et du niveau de l’élève.
Résultats
Les variables, les règles et l’application de la politique de lutte contre le tabagisme ont servi à expliquer l’usage du tabac, après élimination des autres variables. Au primaire, la perception d’une application vigoureuse de la politique antitabac réduisait les probabilités de devenir fumeur (RC = 0,39, IC de 99 % = 0,34-0,44). Au secondaire, non seulement l’application de la politique perdait-elle son effet protecteur (RC = 1,05, IC de 99 % = 1,00-1,10), mais la perception par les élèves de l’existence de règles strictes était liée à un tabagisme accru (RC = 1,32, IC de 99 % = 1,27-1,37).
Discussion
L’application vigoureuse d’une politique de lutte contre le tabagisme à l’école semble être efficace au primaire, mais elle n’est pas aussi utile au secondaire. Les décideurs des écoles secondaires devraient songer à modifier leurs sanctions pour éviter de se mettre les fumeurs à dos.
Footnotes
Supported by: Ontario Tobacco Research Unit through a Graduate Studentship for Research in Tobacco Control, Social Sciences & Humanities Research Council Grant #828-1999-1019 and the Sociobehavioural Cancer Research Network (SCRN). The SCRN is operated by the Canadian Cancer Society and National Cancer Institute of Canada’s Centre for Behavioural Research and Program Evaluation.
Contributor Information
Angela H. Reitsma, Phone: 519-752-3466, Email: reitsmah@mcmaster.ca.
Steve Manske, Phone: 519-888-4518, Email: manske@healthy.uwaterloo.ca.
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