Health & Medical Public Health

Adolescent Smoker's Sources of Smoking Cessation Support

Adolescent Smoker's Sources of Smoking Cessation Support


Data Source and Study Population

A cross-sectional study was conducted using data from the 2012 Smoking, Drinking and Drug Use among Young People survey. This survey is a school-based repeated cross-sectional study conducted annually to estimate the prevalence of smoking among young people in school Year 7 (aged 11–12) to Year 11 (aged 15–16) in England through confidential self-completion questionnaires. The survey used multi-stage probability sampling to select schools by geographical region (response rate 49 % of selected schools), and students within schools (response rate 88 % of eligible students). Parents were able to opt their child out of completing the survey, and otherwise their consent was assumed. Further details of the survey methods are available elsewhere. The anonymised survey dataset was obtained from the UK Data Service; ethical approval was not required for the use of the data.

From the 2012 survey dataset we identified all respondents who were self-reported regular smokers (currently smoking 1 or more cigarettes per week) who reported ever having tried to quit, as well as ex-regular smokers (who used to smoke 1 or more cigarettes per week). Pupils who were non-smokers or those who reported only having smoked once in their lifetime were excluded.

Data were available for current and ex-smokers' reported use of seven different methods of cessation support, all categorised as binary (yes/no) responses:

  1. asked an adult at school for help to quit;

  2. asked family or friends for help to quit;

  3. used nicotine products (in the UK nicotine replacement therapies are licensed for prescription by a doctor to children aged 12+ and children over this age are also able to purchase these products over-the-counter without parental consent);

  4. visited a General Practitioner (GP);

  5. phoned the National Health Service (NHS) smoking helpline (adolescents are able to access the helpline confidentially and anonymously);

  6. used NHS Stop Smoking Services (use is confidential and does not require parental consent);

  7. not spend time with friends who smoke.

Data were also extracted on a range of individual-level characteristics hypothesised to be potentially associated with adolescents' use of smoking cessation support: age (school Year 7 to Year 11); sex; weekly cigarette consumption and number of years smoked (both available for current smokers only, the latter split at the median); whether or not they had played truant, or been excluded from school, in last 12 months; whether any of the people the adolescent lived with smoked; whether they had received lessons at school on smoking in last 12 months; and reported cannabis use (the drug most-frequently used by survey respondents) and alcohol consumption. Finally, an indicator of personal well-being was derived from the level of agreement with five statements each measured on a 5-point scale: my life is going well; my life is just right; I wish I had a different kind of life; I have a good life; I have what I want in life. In line with the approach and category labels used by the survey designers, a total score of 0–9 was used to indicate low wellbeing, and 10–20 to indicate not low wellbeing.

Statistical Analysis

The percentage of respondents reporting use of each type of cessation support was calculated, for smokers and ex-smokers separately, and then combined. Univariable logistic regression was used to calculate odds ratios and 95 % confidence intervals (CIs) for the associations between student characteristics and reported use of cessation support. Variables which were statistically significant, or nearing statistical significance, based on a p-value of 0.05, were entered into a multivariable model for each type of cessation support. Likelihood Ratio Tests were used to examine the effect of removing variables one at a time in order to derive parsimonious models.

All analyses used survey weights to account for the unequal probability of selection of students to the sample by sex and school year. Data management and analysis was performed using Stata 13 (Stata Corp., College Station, Texas, USA).

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