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Visibility of smoking among school­teachers in Spain and associations with student smoking: a cross-sectional study
  1. José Julián Escario1,
  2. Anna V Wilkinson2,3
  1. 1 Faculty of Business and Public Management (Facultad de Empresa y Gestión Pública), University of Zaragoza, Huesca, Spain
  2. 2 School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  3. 3 Division of Epidemiology, Human Genetics and Environmental Sciences, Michael & Susan Dell Center for Healthy Living, Austin, Texas, USA
  1. Correspondence to Dr José Julián Escario; jescario{at}


Objective Limited research has examined the association between smoking among schoolteachers and student smoking. This paper seeks to assess whether smoking visibility on school grounds among schoolteachers is associated with student smoking. We examine both smoking behaviour and the number of cigarettes consumed.

Methods We use a school-based cross-sectional survey carried out by the Spanish Government’s Delegation for the National Plan on Drugs. A total of 27 503 students between 14 and 18 years of age completed an anonymous survey in 2013. Count data regressions were used to assess the association between observed teacher smoking and adolescent smoking behaviour.

Results High levels of visibility of teacher smoking on school grounds increased the odds of being a smoker among students (OR=2.09 and OR=1.64, for the highest levels of visibility), but the impact on the quantity of cigarettes smoked, although positive, was not significant.

Conclusion Teacher smoking on school grounds is associated with student smoking behaviour. Consequently, smoking policies designed to prevent adolescent smoking should address this important social environment.

  • Preventive Medicine
  • adolescents’ smoking
  • teachers’ smoking
  • zero inflated models

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors JJE carried out the statistical analyses. JJE and AVW drafted and revised the manuscript critically for important intellectual content. All authors read and approved the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available from Spanish Government’s Delegation for the National Plan on Drugs. Syntax to reproduce the results presented here is available from the corresponding author on request.

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