Adolescent Socioeconomic and School-Based Social Status, Smoking, and Drinking

Purpose: Relationships between subjective social status (SSS) and health-risk behaviors have received less attention than those between SSS and health. Inconsistent associations between school-based SSS and smoking or drinking might be because it is a single measure reflecting several status dimensions. We investigated how adolescent smoking and drinking are associated with "objective" socioeconomic status (SES), subjective SES, and three dimensions of school-based SSS. Methods: Scottish 13-15 years-olds (N = 2,503) completed questionnaires in school-based surveys, providing information on: "objective" SES (residential deprivation, family affluence); subjective SES (MacArthur Scale youth version); and three school-based SSS dimensions ("SSS-peer", "SSS-scholastic" and "SSS-sports"). We examined associations between each status measure and smoking (ever and weekly) and drinking (ever and usually five or more drinks) and investigated variations according to gender and age. Results: Smoking and heavier drinking were positively associated with residential deprivation; associations with family affluence and subjective SES were weak or nonexistent. Both substances were related to each school-based SSS measure, and these associations were equally strong or stronger than those with deprivation. Although SSS-peer was positively associated with both smoking and (especially heavier) drinking, SSS-scholastic and SSS-sports were negatively associated with both substances. There were no gender differences in the associations and few according to age. Conclusions: Subjective school-based status has stronger associations with adolescent smoking and drinking than "objective" or subjective SES. However, different dimensions of school-based status relate to adolescent smoking and drinking in opposing directions, meaning one measure based on several dimensions might show inconsistent relationships with adolescent substance use. (C) 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc.