The Impact of Public or Private Schools on Smoking Prevalence among Adolescents in 2 Countries

By Leiner, Marie; Arroyave, Ana et al. | Journal of School Health, April 2008 | Go to article overview

The Impact of Public or Private Schools on Smoking Prevalence among Adolescents in 2 Countries


Leiner, Marie, Arroyave, Ana, Blanc, Oscar, Handal, Gilbert, Journal of School Health


Many of the factors that increase the prevalence of smoking among adolescents are independent of the geographic area in which they live. Other factors depend exclusively on geographic area or environment and are sustained by economic, social, and cultural norms that prevail in the adolescent's city, region, or country of residence. Such factors include among others tobacco retail sales to minors, legal policies, cultural beliefs and attitudes, and type of school. Studies have shown that school environments, teacher attitudes regarding smoking, and attendance at public versus private schools have a definite effect on smoking preferences of adolescents. However, further study has revealed unexpected differences: the impact of the school environment may not be the same across national borders. Such may be the case with attendance at public versus private schools on the United States-Mexico border.

Available information indicates that in the United States, the prevalence of smoking is higher among adolescents attending private schools, (1) whereas in Mexico, the prevalence of smoking is higher among adolescents attending public schools, (2) These reported differences were found among adolescents who belonged to different ethnic and cultural backgrounds, living in different environments, and they were measured at different times. Rarely do we have the opportunity to measure, at the same time, smoking preferences in adolescents from similar cultures living in 2 completely different environments in a developed versus a developing country.

At the United States-Mexico border, adolescents exposed to different laws and economic resources share similar cultures and heritage. In the US border area of El Paso, TX (population: 78% Hispanic, 64% Mexican), and Ciudad Juarez, Chihuahua, Mexico, we observed, as part of a cross-sectional study of nonsmoker adolescents, differences in the smoking behaviors of adolescents attending private versus public schools.

A sample of US (1437, mean age = 14.0 years, SD = 1.5) and Mexican (2477, mean age = 14.5 years, SD = 1.4) adolescents living in the United States-Mexico border area and representative of different socioeconomic and geographic areas participated in a questionnaire-based survey that included attendance at public or private schools and a 7-level variable scale to measure adolescents' progress toward regular smoking. (3) The term nonsmoker was used for persons who had never smoked a cigarette and never tried or experimented with smoking. All other adolescents were considered to have been smokers.

Logistic regression analysis was used to calculate prevalence odds ratios (ORs) to identify the effect of school attendance on smoking behaviors. US adolescents who attended private schools had a nonsignificant 10% decrease in the odds of smoking compared to those who attended public schools (Table 1).

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The Impact of Public or Private Schools on Smoking Prevalence among Adolescents in 2 Countries
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