The European Journal of Public Health Advance Access originally published online on March 12, 2007
The European Journal of Public Health 2007 17(6):565-571; doi:10.1093/eurpub/ckm010
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Socioeconomic Inequalities in Health |
Trends in socio-economic differences in tobacco smoking among German schoolchildren, 1994–2002
Matthias Richter1 and Anja Leppin2
1 School of Public Health, University of Bielefeld, Bielefeld, Germany
2 Department of Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
Correspondence: Dr Matthias Richter, University of Bielefeld, School of Public Health, PO 10 01 31, 33501 Bielefeld, Germany, tel: +49 (0) 521.106-3878, fax: +49 (0) 521.106-6433, e-mail: matthias.richter{at}uni-bielefeld.de
Received September 24, 2006 , accepted January 24, 2007
Background: While the graded relationship between socio-economic status (SES) and risk behaviour in adulthood has been the subject of intense research, far less is known about socio-economic differences in health-related behaviour among adolescents. The purpose of the present study is to examine socio-economic differences in adolescent tobacco use in Germany as well as changes in the relationship between 1994 and 2002. Methods: Data were obtained from the ‘Health Behaviour in School-aged Children’ study conducted in the largest federal state of Germany, Northrhine-Westfalia, in 1994, 1998 and 2002. The analysis is based on 11.401 11- to 15-year old students. Socio-economic differences in regular smoking were studied in relation to both parental SES (family affluence) and students own SES (school type). Trends from 1994 to 2002 were analysed for each category of family affluence and school type separately. Results: Family affluence only had a weak effect on regular smoking while for type of school a strong social gradient for smoking was found for both the genders. Trend analyses within the different family affluence and school-type categories showed that smoking has generally increased in all socio-economic groups. The level of socio-economic differences remained virtually unchanged in girls and boys in the past 10 years in Germany. Conclusions: The same relationships of family affluence and school type with smoking have persisted for almost a decade in Germany. Students own SES affects adolescent smoking substantially. Prevention programmes should focus on the school setting in order to tackle current as well as future health inequalities.
Keywords: adolescence, smoking, socio-economic status, trends, HBSC, Germany