Smoking among adolescents: relation to school success, socioeconomic status nutrition and self-esteem

Swiss Med Wkly. 2002 Aug 10;132(31-32):449-54.


Objective: Smoking is a worldwide health problem. This study was designed to evaluate the current status and to examine some potential factors affecting smoking among adolescents.

Design: Descriptive, cross-sectional study.

Setting: Community based study.

Subjects: Of all middle and high school students in Edirne, Turkey, 883 (6.83%) were randomly sampled. Mean age of the subjects was 15.0 +/- 1.8 years.

Method: A self-applied questionnaire was used to collect demographic data, smoking status, school success, nutritional behaviour and self-esteem. The influence of different factors on smoking was evaluated with a logistic regression model.

Results: There were 89 active smokers (11.1%) with the critical age of 15 years for smoking commitment. 609 students (71.9%) were exposed to environmental tobacco smoke. Nutritional behaviour rich in vegetables (OR = 0.813), high school success (OR = 0.807), longer time reserved for homework (OR = 0.718) and eating breakfast (OR= 0.353) were significantly associated with a lower smoking rate. Having a mother, who smoked (OR = 2.155), increasing age (OR = 1.704), increasing number of siblings (OR = 1.351) and eating fast food (OR = 1.150) were associated with significantly higher smoking rates.

Conclusion: An educational programme aimed at changing behaviour and attitude to tobacco smoking and including nutritional counselling with high emphasis on the transition age from early to late adolescence may be a successful primary prevention. In addition projects designed to improve school performance may lead to a reduction in smoking rates while providing an investment in the future of the teenagers.

MeSH terms

  • Achievement*
  • Adolescent
  • Adolescent Behavior / psychology
  • Adult
  • Child
  • Cross-Sectional Studies
  • Diet*
  • Family Characteristics
  • Female
  • Humans
  • Logistic Models
  • Male
  • Parents
  • Self Concept*
  • Smoking / epidemiology*
  • Smoking / psychology*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Turkey / epidemiology