Social network and inequalities in smoking amongst school-aged adolescents in six European countries

Lorant V, Rojas VS, Robert PO, Kinnunen JM, Kuipers MA, Moor I, Roscillo G, Alves J, Rimpelä A, Federico B, Richter M, Perelman J, Kunst AE.

Int J Public Health. 2016 May 12. [Epub ahead of print]

Objectives

Smoking contributes to socio-economic health inequalities; but it is unclear how smoking inequalities emerge at a young age. So far, little attention has been paid to the role of friendship ties. We hypothesised that the combination of peer exposure and friendship social homophily may contribute to socio-economic inequalities in smoking at school.

Methods

In 2013, a social network survey was carried out in 50 schools in six medium-size European cities (Namur, Tampere, Hanover, Latina, Amersfoort, and Coimbra). Adolescents in grades corresponding to the 14-to-16 age group were recruited (n = 11.015, participation rate = 79.4 %). We modelled adolescents’ smoking behaviour as a function of socio-economic background, and analysed the mediating role of social homophily and peer exposure.

Results

Lower socio-economic groups were more likely to smoke and were more frequently exposed to smoking by their close and distant friends, compared with adolescents of higher SES. The smoking risk of the lowest socio-economic group decreased after controlling for friends smoking and social homophily.

Conclusions

Smoking socio-economic inequalities amongst adolescents are driven by friendship networks.

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