Tobacco use among adolescents in Scotland: profile and trends

EXECUTIVE SUMMARY

The Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) has been running regularly since 1982, surveying S2 and S4 pupils on their tobacco, alcohol and drug use, which is contextualised alongside other data on lifestyle, health and social factors. The length of time the survey has been conducted and the consistency of its aims and structure provide a unique resource for gaining insight into how adolescent substance use and lifestyles have changed over time. The survey data from 1990 to 2013 has been combined to allow more detailed analysis and the identification of trends in substance. This report is one of the first uses of this dataset, exploring how adolescent smoking and factors associated with it have changed over time.

PREVALENCE

• The proportion of 13 and 15 year olds who regularly smoke has decreased over time and is now at its lowest level since the survey began. In 2013, 2% of 13 year olds smoked regularly, down from a peak of 8% in 1998, and 9% of 15 year olds, from a peak of 29% in 1996.
• The percentage of pupils who do not smoke has risen steadily, over most waves of the survey.
• Girls had consistently reported higher rates of regular smoking than boys of the same age over most of the survey, although the gap has narrowed to the point where there is no difference between the genders in 2013.
• Smoking has decreased steadily in most at risk groups, including those living in deprived areas, those with mental health problems and pupils living with a single parent, but pupils in these groups are still more likely to be regular smokers.

SOURCES OF CIGARETTES

• The percentage of regular smokers who directly purchase cigarettes from primary sources remained relatively stable until 2008 then decreased sharply in the 2008 and 2010 surveys. In 1990, 94% of 15 year old regular smokers had obtained cigarettes from any primary source compared to 33% in 2013; and in 1990, 87% had purchased cigarettes from a newsagent, tobacconist or sweetshop compared to 22% in 2013. The age of sale for tobacco was increased from 16 to 18 in 2007 and the Tobacco Retailer Register was introduced in 2010.
• The overall proportion of regular smokers obtaining cigarettes from secondary sources, such as asking an adult to buy them or being given them by others, has remained comparatively stable since 1990.

FAMILY, FRIENDS, SOCIETY AND HEALTH

• Across the whole time series, pupils who report that at least one parent, at least one sibling, their boy/girlfriend or their best friend smokes are all much more likely to be regular smokers.
• Smokers are most likely to say that 'all' or 'mostly all' of their friends smoke; non-smokers are very unlikely to have many friends who smoke.
• Regular smokers are less likely to be living with both parents than in some other family structure.
• Pupils who report that both parents know little about of how they spend their time are more likely to be smokers.
• Activities associated with increased probability of being a regular smoker include regularly hanging out on the street, going to concerts or gigs and being out most evenings. Pupils who play sports at least weekly are less likely to be regular smokers.
• Pupils who do not like school are more likely to be regular smokers than those that do. Additionally, those who have been excluded or have truanted from school are far more likely to smoke than those who have not.
• There is no clear link between feeling stressed by school work and smoking.
• Pupils who report having physical health or mental wellbeing issues are consistently far more likely to be regular smokers than others.

ATTITUDES TO SMOKING

• Across the time series, most regular smokers report that their family knows that they smoke, but this is not the case with occasional smokers. The responses of families to their smoking - or how the child thinks they would respond - has not substantially changed over time: most would try to stop them smoking or try to persuade them to stop.
• The proportion of pupils who think it is ok to try a cigarette to see what it is like has declined steadily with time.
• Almost all pupils (regular, occasional and non-smokers) agree that smoking can cause lung cancer and heart disease.
• A minority of pupils do, however, think that smoking helps people to cope with life or gives people confidence, and a majority believe that smoking helps people relax if they are nervous.
• Regular and occasional smokers are more likely than non-smokers to agree with statements about "positive" aspects of smoking.
• Over time, the proportion of regular smokers wishing to give up has remained constant; the proportion saying they do not want to stop has increased, while 'don't knows' have fallen.

EQUALITIES

• Pupils who live in deprived areas, receive free school meals, or describe their family as being 'not well off at all', are more likely to be regular smokers.
• The gap between female and males regular smoking rates has decreased over time, but girls are still more likely than boys to have tried at least one cigarette and are more likely to smoke if they have characteristics which place them at higher risk of substance use, especially those who have poor mental wellbeing.

PREDICTORS OF SMOKING

• The strongest predictors of regular smoking from the logistic regression model are truancy and exclusion, playing sports at least weekly, hanging around on the street at least weekly, parental knowledge of the child's activities, the age of their friend group, the number of evenings spent out, and what the pupil thinks they will do after leaving school.

• In the logistic regression poor mental wellbeing is only a weak predictor of smoking for both genders, but has a larger effect for girls who have poorer mental wellbeing.