Adolescents aged 13-17 who smoke conventional cigarettes and e-cigarettes against selected family factors, school performance and health literacy

Introduction:
Despite declining tobacco smoking trends, the use of replacement products is growing and the market is rapidly expanding. The aim of the study was to present the prevalence and intensity of conventional and e-cigarette smoking among Polish adolescents in relation to selected demographic factors, family characteristics and individual resources.

Material and methods:
The study included 5279 students of three school grades (aged 13, 15, 17 years) surveyed in 2018 within the international Health Behaviour in School-aged Children Study (HBSC). Two standardised indices of combined conventional cigarettes and e-cigarettes smoking were constructed, covering the whole life (INDLT) and the last 30 days (IND30) respectively.

Results:
Smoking prevalence increases with age, with gender differences emerging in 15-year-olds to the disadvantage of girls, which was not observed in 13- and 17-year-olds. According to general linear model, age, school performance, family wealth and a smoking father or mother are independent predictors of INDLT indicator variability. Regarding IND30, in addition to the same factors, the influence of gender, family subjective social position and health literacy were also revealed.

Discussion:
In adolescence, the determinants of smoking intensity may differ from those in evidence in the adult population. Family and school factors related to the modelling of behaviour and shaping health literacy are of great importance.

Conclusions:
The analyses confirm the need to monitor adolescents’ smoking intensity, including tobacco substitutes and different time perspectives. Particular attention was paid to health literacy as a personal resource, which can be shaped by the family and school health education to protect against risk behaviour.