Self-reported school difficulties and tobacco use among fourth- to seventh-grade students

This study examined the relationship between academic and behavioral difficulties at school, and tobacco use in students. Participants included 1,219 students in fourth to seventh grade at the time of enrollment. Interviews were repeated eight months later with 85% of baseline participants. Telephone interviews assessed use of cigarettes, cigars, and chewing tobacco; students also were asked if they liked school, how often they got in trouble at school, and how well they were doing in school. At baseline, students reporting school difficulties were 1.4-5.6 times more likely to report a lifetime history of cigarette, cigar, and chewing tobacco use relative to students who did not report these difficulties. Average to below-average academic performance at baseline was predictive of new cigarette use at the eight-month follow-up (Relative Risk = 3.35; 95% Confidence Interval = [1.36, 8.22]). Self-reported school difficulties are associated with lifetime use of all major forms of tobacco and are predictive of future cigarette use in fourth- to seventh-grade students.