The Relationships among School Connectedness, Socioeconomic Status, Drinking and Smoking Behaviors in High School Students in Okinawa, Japan

<p>　School connectedness is supposed to have a significant role in smoking and drinking prevention among young people. This study examined the relationships between school connectedness, socioeconomic status (SES), and drinking and smoking behaviors in high school students.</p><p>　A self-administered anonymous questionnaire was conducted among 3,248 students（aged 15-18）at 29 public high schools in Okinawa, Japan. Drinking and smoking behaviors were assessed using questions adapted from the Youth Risk Behavior Surveillance conducted by the U.S. Center for Disease Control and Prevention. A current drinker or smoker was defined as one who consumed an alcoholic beverage or smoked cigarettes at least one day in the past month. SES was assessed by parent's educational level. School connectedness was measured by the sum of a scale constructed from three items, ‛I like school', ‛School is a nice place to be', and ‛Sense of belonging at school'. Multivariate logistic regression models were performed to examine the associations among school connectedness, SES, drinking and smoking behaviors.</p><p>　After adjustment for gender, grade, school type, and family structure, students in lower SES group were more likely to drink and smoke than those in higher SES group. Students with lower school connectedness were more likely to drink and smoke than those with higher school connectedness. A combination of lower school connectedness and lower SES produced the strongest associations with drinking and smoking behaviors. On the other hand, students with lower SES but higher school connectedness did not significantly increase the odds of drinking and smoking.</p><p>　This study showed that school connectedness and SES were associated with drinking and smoking behaviors in high school students. The combination of school connectedness and SES had different influences on drinking and smoking behaviors. The findings suggest that promoting school connectedness may be important to prevent adolescent drinking and smoking, especially among lower SES group.</p>