Pocket money and smoking behaviors among adolescents: evidence ...

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2Institute of Medical Sociology, Martin-Luther University of Halle, Halle,. Germany. 3Department of Human Sciences, Society and Health, University of Cassino.
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European Journal of Public Health, Vol. 25, Supplement 3, 2015

Pocket money and smoking behaviors among adolescents: evidence from a study on 6 European cities Julian Perelman J Perelman1, J Alves1, T Pfoertner2, I Moor2, B Federico3, M Kuipers4, M Richte2, A Rimpela5, AE Kunst4, V Lorant6 1 Escola Nacional de Sau´de Pu´blica, Universidade Nova de Lisboa, Lisbon, Portugal 2 Institute of Medical Sociology, Martin-Luther University of Halle, Halle, Germany 3 Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Italy 4 Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 5 School of Health Sciences, University of Tampere, Tampere, Finland 6 Institute of Health and Society, Universite´ Catholique de Louvain, Louvain-la-Neuve, Belgium Contact: [email protected]

Background High prices are considered a powerful barrier against smoking among adolescents. Though, the economic constraint may be weak if pocket money represents a substantial revenue. This study investigates the association between pocket money and smoking habits among adolescents. Methods We used the data from the SILNE project, which surveyed adolescents aged 14–17 years old at 50 schools from 6 European cities in 2013 (n = 10,794). We modeled smoking behaviors (regular smoking, nicotine dependence, smoking intensity, and likelihood of buying cigarettes) as a function

of pocket money, adjusting for age, sex, and peers’ and parents’ smoking habits, using logistic and linear regressions. In order to examine the causality, we (i) adjusted for the socioeconomic (SE) background, to discard that pocket money is a mere proxy of SE circumstances; (ii) adjusted for the age of smoking initiation, to discard reverse causation; (iii) tested the model among the different age groups and cities. Results Adolescents in the highest pocket money quintile were more likely to be regular smokers than those in the lowest quintile, regardless of SE factors and age at initiation (OR = 3.1; p < 0.01). This association was significant at all ages from 14 to 17, and for the 6 cities. Regular smokers in the highest pocket money quintile smoked on average more 4.2 cigarettes per day (p < 0.01), had a significantly higher level of dependence to nicotine (b = 1.8, p < 0.01), and were more likely to buy their cigarettes (OR = 4.3; p < 0.01). Conclusion Pocket money is an independent and consistent predictor of smoking among adolescents. It determines the act of buying cigarettes, the level of addiction, and the intensity of smoking. The effectiveness of high prices to limit smoking among adolescents may be counterbalanced by access to pocket money, reinforcing the need of alternative strategies grounded on bans. Key messages  Pocket money is an independent and consistent predictor of smoking among adolescents. It determines the act of buying cigarettes, the level of addiction, and the intensity of smoking  The effectiveness of high prices to limit smoking among adolescents may be counterbalanced by access to pocket money, reinforcing the need of alternative strategies grounded on bans