School factors and smoking prevalence among high school students in Japan

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Abstract
The purpose of this study was to analyze the relationship between student smoking prevalence by school and school factors. Junior and senior high schools were selected from throughout Japan using a simple random sampling. One hundred junior high schools and 50 senior high schools were randomly selected. Of these 70 junior high schools (70%) and 33 senior high schools (66%) responded to this survey. Self-administered anonymous questionnaires were completed by all enrolled students in each school. The principal of each school completed a school questionnaire about school factors. The smoking rate of male teachers was significantly related to the student smoking rate in junior high schools. This factor was still associated with the student smoking rate after adjusting for family smoking status. Surprisingly, the smoking rates for junior high school boys in schools with a school policy against teachers smoking were higher than those of schools without one. The dropout rate and the proportion of students who went on to college were significantly related to the smoking rates among senior high school students of both sexes. The regular-smoker rate of boys in schools with health education on smoking was more likely to be low. It is important to take account of school factors in designing smoking control programs for junior and senior high schools.