Dataset Information

Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002-2015.

ABSTRACT:

Objectives

Adolescent smoking has declined in New Zealand and in many other countries since the late 1990s, yet the reasons for the decline are not well understood. We investigated the extent to which established risk factors for adolescent smoking (parental, sibling and peer smoking, and exposure to smoking in the home) explained the downward trend.

Design

Trend analysis of repeat cross-sectional data from an annual nationally representative survey.

Setting

New Zealand.

Participants

Secondary school students aged 14-15 (n=398?221).

Outcome measure

Regular (at least monthly) smoking.

Methods

For each risk factor (parental smoking, best friend smoking, older sibling smoking and past week exposure to smoking in the home) we plotted prevalence of exposure, 2002-2015. Next, using multivariable logistic regression, we modelled the trend in regular smoking (expressed as an OR for year) adjusting for age, sex, ethnicity and socioeconomic position. The risk factors were added to the model-individually and collectively-to test whether they attenuated the OR for year.

Results

Exposure to all risk factors except 'past week exposure to smoking in the home' decreased between 2002 and 2015. We observed a strong downward trend in regular smoking among adolescents (OR=0.88 per year, 95%?CI 0.88 to 0.88, p<0.001). 'Best friend smoking' was the only risk factor that significantly attenuated the trend. However, due to circularity, this factor provides an unsatisfactory explanation for population level smoking decline.

Conclusions

The established risk factors that we explored do not appear to have contributed to the remarkable decline in adolescent smoking in New Zealand between 2003 and 2015. Further research is needed to assess the possible contribution of factors outside our model, such as changes in the policy context, the social meaning of smoking and broader social and economic conditions.

SUBMITTER: Ball J

PROVIDER: S-EPMC6224735 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002-2015.

Ball Jude J Sim Dalice D Edwards Richard R

BMJ open 20181025 10

<h4>Objectives</h4>Adolescent smoking has declined in New Zealand and in many other countries since the late 1990s, yet the reasons for the decline are not well understood. We investigated the extent to which established risk factors for adolescent smoking (parental, sibling and peer smoking, and exposure to smoking in the home) explained the downward trend.<h4>Design</h4>Trend analysis of repeat cross-sectional data from an annual nationally representative survey.<h4>Setting</h4>New Zealand.<h4 ...[more]

PMID: 30366911

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Project description:BackgroundNon-drinking among young people has increased over the past decade in England, yet the underlying factor driving this change is unknown. Traditionally non-drinking has been found to be associated with lower socio-economic status and poorer health. This study explores among which sub-groups non-drinking has increased, and how this correlates with changes in drinking patterns, to identify whether behaviours are becoming more polarised, or reduction is widespread among young people.MethodsAmong participants aged 16 to 24 years (N?=?9699), within the annual cross-sectional nationally-representative Health Survey for England 2005-2015 datasets, the following analyses were conducted: 1) The proportion of non-drinkers among social-demographic and health sub-groups by year, and tests for linear trends among sub-groups, adjusting for age were calculated. In pooled analyses, an interaction between year and each variable was modelled in sex- and age-adjusted logistic regression models on the odds of being a non-drinker versus drinker 2) At the population level, spearman correlation co-efficients were calculated between the proportion non-drinking and the mean alcohol units consumed and binge drinking on the heaviest drinking day, by year. Ordinary least squares regression analyses were used, modelling the proportion non-drinking as the independent variable, and the mean units/binge drinking as the dependent variable.ResultsRates of non-drinking increased from 18% (95%CI 16-22%) in 2005 to 29% (25-33%) in 2015 (test for trend; p?<?0.001), largely attributable to increases in lifetime abstention. Not drinking in the past week increased from 35% (32-39%) to 50% (45-55%) (p?<?0.001). Significant linear increases in non-drinking were found among most sub-groups including healthier sub-groups (non-smokers, those with high physical activity and good mental health), white ethnicity, north and south regions, in full-time education, and employed. No significant increases in non-drinking were found among smokers, ethnic minorities and those with poor mental health. At the population-level, significant negative correlations were found between increases in non-drinking and declines in the mean units consumed (??=?-?0.85, p?<?0.001), and binge drinking (??=?-?0.87, p?<?0.001).ConclusionIncreases in non-drinking among young people has coincided with a delayed initiation into alcohol consumption, and are to be welcomed. Future research should explore attitudes towards drinking among young people.

Dataset Information

Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002-2015.

Objectives

Design

Setting

Participants

Outcome measure

Methods

Results

Conclusions

Publications

Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002-2015.

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