Socioeconomic Differences in Smoking Among Finnish Adolescents From 1977 to 2007

doi:10.1016/j.jadohealth.2010.03.012

Journal of Adolescent Health

Volume 47, Issue 5, November 2010, Pages 479-487

https://doi.org/10.1016/j.jadohealth.2010.03.012 Get rights and content

Abstract

Purpose

Persistence of socioeconomic differences in smoking among adolescents over time is unexplored. We investigated the changes in smoking among 12–18-year-old Finns from 1977 to 2007 using multiple indicators of socioeconomic status (SES) to determine whether differences between socioeconomic groups increase over time, with reduced smoking in higher socioeconomic groups.

Methods

Nationwide biennial surveys were conducted since 1977 (response rate, 59%–88%; N = 96,747) using familial and individual social position (school performance/career) indicators. Associations between socioeconomic indicators and smoking were evaluated using logistic regression analysis.

Results

Socioeconomic differences in smoking measured by familial SES or individual social position persisted over time, with higher rates in lower SES groups. Individual social position was more strongly related to smoking than familial SES. Differences between groups assessed by individual social position increased over time: the difference in smoking prevalence between groups with the lowest and highest individual social position among 12–14-year-old girls and boys, respectively, was 22% and 28% in 1977–1983, and 45% and 34% in 2001–2007; and in 16–18-year-old girls, 33% in 1977–1983 and 48% in 2001–2007. Smoking differences in relation to father's education increased over time: the difference in 12–14-year-old girls and boys, respectively, between the lowest and highest SES groups was 6% and 5% in 1977–1983 and 9% and 8.5% in 2001–2007; and in 16–18-year-old girls and boys, respectively, 7% and 10% in 1977–1983 and 13% and 14.5% in 2001–2007.

Conclusions

Differences between socioeconomic groups among Finnish adolescents persisted or increased over 30 years, and predict differences in smoking-related diseases between socioeconomic groups in adulthood.

Section snippets

Data source

The data were collected as part of a national monitoring system of adolescent health and health behaviors, the Adolescent Health and Lifestyle Survey. The survey instrument consists of a 12-page self-administered questionnaire mailed biennially since 1977 to a nationally representative sample of independent samples of adolescents aged 12, 14, 16, and 18 years, with two reminders sent to nonrespondents (N = 2,832–6,503; yearly response rate 59%–88%, total respondents N = 96,747). The samples

Smoking by adolescent's familial SES

Children in lower socioeconomic groups smoked more than children in higher socioeconomic groups, whether measured by father's or mother's education (Table 3). The only exception was that smoking prevalence for adolescent boys whose fathers were farmers did not differ from the reference group and smoking prevalence was lower among adolescent daughters of farmers than among those of upper white-collar employees.

There was a statistically significant interaction between the study period and the

Summary of the results

Using a nationally representative large sample, this study shows that there are socioeconomic differences in smoking behavior among Finnish adolescents. Smoking is more strongly linked to an adolescent's individual social position than to his or her familial SES. Over the 30-year period, the differences between socioeconomic groups persisted and, in some groups, even increased over time. An increase in smoking was observed among 12–14-year-olds girls whose school performance was poor, and among

Conclusions

Despite efforts targeted at reducing health inequalities in Finland, the results of the present study indicate that there are persistent or even increasing socioeconomic differences in smoking behavior among Finnish adolescents, whether measured by familial SES or the adolescent's individual social position (school performance and school career), to the disadvantage of those in lower socioeconomic groups. Individual social position was, however, a more important predictor of smoking than

Acknowledgments

The authors thank Mr Lasse Pere of the School of Public Health, University of Tampere, for data management. This study was financially supported by the Ministry of Social Affairs and Health (the §27 Appropriation of the Tobacco Act), the Competitive Research Funding of the Pirkanmaa Hospital District, the Finnish Cultural Foundation Central Fund, Academy of Finland Grant number 130481, Juho Vainion Foundation, and the University of Tampere Research Stipend.

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Within the same school, the perceived smoking prevalence can vary to a large extent between groups of students (Brown et al., 2010; Conley Thomson et al., 2005; Javier et al., 2013; Pedersen et al., 2013; Unger and Rohrbach, 2002). For example, perceived smoking prevalence rates have been found to be higher in adolescents of lower socioeconomic position (SEP) than in their high SEP counterparts (Doku et al., 2010; Pförtner et al., 2014; Richter and Leppin, 2007), in females than in males (Javier et al., 2013; Pedersen et al., 2013; Unger and Rohrbach, 2002) and in adolescents who have more friends who are smokers (Conley Thomson et al., 2005; Unger and Rohrbach, 2002). However, subgroup variations have hitherto only been studied in the USA, and not in the European context.
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Original articleSocioeconomic Differences in Smoking Among Finnish Adolescents From 1977 to 2007

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Data source

Smoking by adolescent's familial SES

Summary of the results

Conclusions

Acknowledgments

Soc Sci Res

Soc Sci Med

Soc Sci Med

Soc Sci Med

Soc Sci Med

Addict Behav

J Appl Dev Psychol

Sociodemographic predictors of success in smoking intervention

Tob Control

Smoke intake among smokers is higher in lower socioeconomic groups

Tob Control

Diffusion of Innovations

A descriptive model of the cigarette epidemic in developed countries

Tob Control

The lung cancer epidemic in developed countries

Educational differences in smoking: International comparison

BMJ

The Scandinavian welfare states: Achievements, crisis and prospects

Universal public social care and health services

Cuts in and reform of the Nordic Cash Benefit Systems

The Tobacco Report. Right to Live a Smoke-Free Life (English abstract)

Health Behaviour and Health of the Finnish Adult Population, Spring 2007

Socioeconomic status and smoking. Analysing inequalities with multiple indicators

Eur J Public Health

Original article
Socioeconomic Differences in Smoking Among Finnish Adolescents From 1977 to 2007