Tobacco use among adolescents in Scotland: profile and trends

7. CONCLUSION

Adolescent smoking prevalence has fallen over the lifetime of SALSUS. As most smokers take up the habit in their teens or early twenties, this is encouraging and will help Scotland to make progress towards the aspiration of a 'smoke-free Scotland by 2034 where 5% or less of adults smoke.

The marked decline in 13 and 15 year olds who have purchased from primary sources, especially small independent stores, between 2006 and 2013 shows that legislative measures to control youth access to cigarettes through these sources have been successful. Restricting access to tobacco for under-18s has had a direct impact on smoking rates, complementing other policy changes (such as the ban on smoking in enclosed public spaces) and the reduced social acceptability of smoking in the general population.

The percentage of smokers who have obtained cigarettes through secondary sources has remained relatively constant over time. The percentage who have used 'proxy purchase', that is have asked an adult to buy cigarettes for them, remains at almost a third, despite there being an offence of 'proxy purchase' since 2010. The challenge remains of persuading adults not to buy tobacco for children and young people.

This will likely have to be done by changing attitudes although SALSUS suggests that both family attitudes towards smoking and adolescent smokers' attitudes have not changed radically. It also suggests that more remains to be done to tackle common misconceptions held by many adolescents that smoking helps people cope with the stresses and strains of everyday life. Nevertheless, there has for many years been a steady increase in the proportion of pupils choosing never to smoke.

Reducing smoking prevalence further may require targeting the social contexts and meanings of smoking and the kinds of activities popular with regular smokers. Promoting the benefits of sports and activities to bolster and protect mental wellbeing (particularly for girls) will have wider health and social benefits for young people, as will tackling deprivation and adult smoking.

This report demonstrates the value of the combined SALSUS time series data-set in improving our understanding of the health behaviours of young people in Scotland, identifying factors which have been consistently associated with smoking and where there have been changes, including ones which have followed significant policy measures. It provides a useful example of how analysis can be undertaken with the dataset.