gms | German Medical Science

Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

Socioeconomic differences in adolescent smoking: the equalising impact of peer and school context

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  • Matthias Richter - Universität Bielefeld, Bielefeld
  • Thomas Lampert - Robert Koch-Institut, Berlin

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds902

The electronic version of this article is the complete one and can be found online at:

Published: September 6, 2007

© 2007 Richter et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Several studies suggested that socioeconomic status might lose its relevance for adolescent health and health behaviour, while factors and mechanisms associated with the peer group and the school setting are getting increasingly important and compose a moderating buffer against the health-compromising effect of socioeconomic status. The aim of the paper is to examine socioeconomic differences in regular tobacco smoking among German adolescents and to analyse the importance of peer and school factors for tobacco use in relation to parental socioeconomic status.

Methods: Data were obtained from the German part of the cross-sectional "Health Behaviour in School-aged Children" survey in 2001/02 with a total of 5,650 respondents aged 11- to 15-years. Socioeconomic status was assessed using the family affluence scale. Bi- and multivariate logistic regression models adjusted for age were used to determine the independent effect of SES, peer and school variables on adolescent smoking, separately for girls and boys.

Results: Adolescent tobacco use was found to be largely unrelated to family affluence. No socioeconomic differences in regular smoking were found in boys and only minor differences in girls. Bivariate analyses showed that several social and psychosocial peer and school factors were significantly associated with smoking among both girls and boys. Peer variables were generally more important for the prediction of adolescent smoking. In multivariate analyses, peer and school factors had a much larger effect on regular smoking than family affluence suggesting that the peer and school context is more important for adolescent smoking than socioeconomic background.

Discussion: The findings support the idea of an equalising impact of peer and school variables on socioeconomic differences in smoking in early adolescence, independently of gender. Health promoting actions focussing on smoking need to be further implemented in the context of schools and need to take the relationship to peers into account.