Harsh school atmosphere may foster student smoking

NEW YORK (Reuters Health) - Students at high schools that value caring and inclusiveness are significantly less likely to be smokers than their peers at schools placing a heavier emphasis on academics, Scottish researchers report.

Students' attitudes toward a school and the quality of student-teacher relationships also appeared to play a role in whether or not students chose to smoke cigarettes, especially for boys.

"Schools can make a difference," Dr. Marion Henderson of the Medical Research Council Social and Public Health Sciences in Glasgow, who led the study, told Reuters Health. "It's worth schools trying to think about the social environments they're creating."

Current anti-smoking efforts at schools, which usually focus on individuals rather than the school environment, have done little to discourage smoking among teens, Henderson and her colleagues note in the journal BMC Public Health.

They sought to investigate whether the quality of the school environment itself might be related to students' likelihood of picking up the habit by looking at 5,092 students at 24 high schools in Scotland.

Overall, 25 percent of males and 39 percent of females smoked. But smoking rates varied sharply from school to school, from a low of 8 percent to a high of 33 percent for male students. For girls, the percentage of smokers ranged from 28 percent to 49 percent.

Even after the researchers accounted for factors associated with smoking such as a student's socioeconomic status, the amount of spending money he or she had, or whether a student lived with both parents, school-to-school differences in smoking rates remained.

Kids attending schools with worse student-teacher relationships as rated by students, teachers and the researchers themselves were more likely to be smokers. And when more students said they didn't like their school, the percentage of smokers in the student body also was higher. Both factors had a particularly strong influence on whether or not boys smoked.

The researchers also found male students at affluent schools were more likely to be smokers if student-teacher relationships at the school were poor. "The affluent schools, particularly those with poor relationships, may be more likely than deprived schools to have an academic focus, perhaps at the cost of the social climate or health-related goals," the researchers suggest.

The findings in this study make it clear that it's not only individual factors such as deprivation that influence the likelihood a student will smoke. "Once you've leveled the playing field for these things, schools can make a difference (in) smoking just by being nicer social environments to be in," Henderson said in an interview.

Schools could build more positive environments by finding ways to make all students feel valued, even if they are not top academic achievers, the researcher said. This might include offering apprenticeships and practical training to those who aren't necessarily "university material," Henderson suggested. And making sure that teachers are people that the students respect and like could ensure that any health-related messages they offer won't be dismissed, she added.

SOURCE: BMC Public Health 2008.