[Smoking behavior and alcohol drinking in students in a rural area of East Germany]

The present investigation ("Torgau Study") provides epidemiological information on a target population which in the past has hardly been in the focus of health promotion activities: the subgroup of children and adolescents of rural regions in Eastern Germany. A total survey was conducted that encompassed all classes from grade 6 to 10 of all schools in the district of Torgau (Saxony). Together, 5,925 students in the age range 12 to 16 years participated in this study (participation rate: 81.3%). The results provide a differentiated picture of their smoking behavior and alcohol use broken down by gender, school-type and grade. With respect to smoking the data show that the prevalence of regular smokers (i.e., daily smokers) in grade 10 is 41% in the Mittelschule (the school-type with a stronger vocational orientation) and 29% in the Gymnasium (the school-type with a university-preparatory curriculum). 51.9% of all students report that at least one parent smokes. There is a highly significant association between smoking status of the parents and smoking status of their children. The analysis of reasons for smoking highlight the stepwise transition into nicotine dependency from a psychological perspective. Most of the adolescents (about 80%) know about the dangers of passive smoking. However, with increasing age this knowledge loses its subjective relevance because dissonance-reducing strategies are applied ("doesn't matter"-attitude). Among girls, even in grade 10, there are almost no daily alcohol consumers (less than 1%); among boys in grade 10 the rate of daily alcohol users is about 8%. The rate of those 10th graders who consume alcoholic beverages at least once a week is however 30.6% (girls: 18.7%; boys: 44.2%). The longer the alcohol experience the more specific become the social and emotional motives for drinking. Altogether, the results suggest that efforts to prevent substance misuse in the rural regions of Eastern Germany are as necessary as in other regions. But the time has come that innovative approaches of drug prevention that are implemented and evaluated mostly in the bigger cities should also be started in the rural regions (not only of Eastern Germany), and should be adapted to the specific conditions there.