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Open Access Research article

Explaining socio-economic differences in intention to smoke among primary school children

Henricus-Paul Cremers1*, Anke Oenema1, Liesbeth Mercken1, Math Candel2 and Hein de Vries1

Author Affiliations

1 Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands

2 Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands

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BMC Public Health 2014, 14:191  doi:10.1186/1471-2458-14-191

Published: 21 February 2014

Abstract

Background

Smoking prevalence is higher among low socio-economic status (LSES) groups, and this difference may originate from a higher intention to smoke in childhood. This study aims to identify factors that explain differences in intention to smoke between children living in high socio-economic status (HSES) and LSES neighbourhoods.

Methods

Cross-sectional data were derived from the baseline assessment of a smoking prevention intervention study. Dutch primary school children, aged 10 – 11 years (N = 2,612), completed a web-based questionnaire about their attitude, subjective norm, self-efficacy expectations, modelling and intention to smoke. Linear and logistic regression analyses were performed to assess potential individual cognitive (attitude, subjective norm and self-efficacy) and social environmental (modelling) mediators between SES and intention to smoke.

Results

Multiple mediation models indicated that modelling mediated the association between SES (B = -0.09 (p < 0.01)) and intention to smoke (B = 1.06 (p < 0.01)). Mainly the father, mother and other family members mediated this association. Gender did not moderate the association between SES and intention to smoke and the potential mediators indicating that there are no differences in mediating factors between boys and girls.

Conclusions

This study indicates that future smoking prevention studies may focus on the social environment to prevent smoking onset. However, replication of this study is warranted.

Trial registration

This study was approved by the Medical Ethics Committee of the Atrium-Orbis-Zuyd Hospital (NL32093.096.11 / MEC 11-T-25) and registered in the Dutch Trial Register (NTR3116).

Keywords:
Socio-economic status; Intention to smoke; Primary school; Mediation analyses