The visibility of smoking in Europe and its relationship with youth's positive beliefs about smoking.

OBJECTIVES

To determine adolescent-reported visibility of smoking in different public and private spaces in Europe and associations between smoking visibility and beliefs about the benefits of smoking.

METHODS

We used SILNE-R cross-sectional survey data (2016/2017) of 10,798 14-16-year-old students from 55 secondary schools in seven European cities. Respondents reported for private and public spaces whether they had seen others smoke there in the last 6 months. Beliefs about the benefits of smoking were measured on a 7-item scale; higher scores indicated more positive beliefs. Multilevel linear regression analyses determined associations while controlling for potential confounders and stratifying by smoking status.

RESULTS

Most students reported observing others smoke in public spaces, especially at train/bus stations (84%). Positive beliefs about smoking of never smokers were positively associated with seeing others smoke in train/bus stations and leisure/sports facilities, but not at home, a friend's home, restaurants or bars, when fully adjusted. Associations were of similar magnitude for ever smokers.

CONCLUSIONS

Smoking in several public places is highly visible to adolescents. Reducing this visibility might weaken positive beliefs that adolescents have about smoking.