Although low socio-economic status is associated with an increased liability to smoke, performing well at school can mitigate this effect. A new study, published in BioMed Central's open access International Journal for Equity in Health, has shown that high-achieving schoolchildren, even those from poor backgrounds, are less likely to smoke.
Christina Schnohr led a team of researchers from the University of Copenhagen's Institute of Public Health who surveyed 20,399 schoolchildren from the UK, Denmark, Sweden, Norway and Finland. She said, "Above average academic achievement was associated with lower risk of smoking. Teachers and politicians may find this information useful, and allocate resources to give higher priority to a supportive environment in schools especially for children and adolescents in lower social groups. This might contribute to reducing smoking in this group".
The researchers' study confirmed that children from less well-off families are more likely to smoke, and are less likely to perform well at school - although this latter effect was least pronounced in the UK. However, those poorer children who did perform well in class were also less likely to be smokers. Schnohr said, "This mediating role of academic achievement emphasizes the role of teachers in supporting students from deprived families. If they can focus on students from lower socio-economic positions, it might help reduce the social inequality in smoking prevalence".
Smoking is a major cause of the inequality in mortality between rich and poor. This research suggests that one intervention, improved education for children from poor families, should be both implementable and effective in reducing the gap. As the association between academic achievement and lower smoking rates may not be a causal one, further research is required before a direct effect can be assumed.
1. School-related mediators in social inequalities in smoking: A comparative cross-sectional study of 20,399 adolescents.
Christina W. Schnohr, Svend Kreiner, Mette Rasmussen, Pernille Due and Finn Diderichsen
International Journal for Equity in Health (in press)
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2. International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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