Smoking can “kill” school attendance

Submitted on Thu, 12/15/2016 - 13:21

Smoking/ Photo: Jonne Renvall


Research shows that adolescent smoking correlates with poor academic performance and a low education in adulthood. Even at the age of twelve, health compromising behaviours predict a low educational level.

In Finland, research results show that smoking strongly correlates with the length of adolescents’ education and how well they do at school. The habit of smoking is often learned from such role models as one’s own parents and even grandparents. The good news is that smoking is steadily decreasing among the Finnish youth.

On average, the well-being of Finnish youths is high. Smoking and alcohol consumption have decreased for several years. On the population level, depression has not increased even though that is often debated. Most young people are doing better than before.

Unfortunately, this is not the whole truth. There are groups of teenagers whose problems are getting more severe. For example, mental health problems accumulate in the disadvantaged groups; depression has increased among boys with unemployed, low educated parents while no change is observed in the population in general. Alcohol and depression are closely related in this disadvantaged group.

“This is obviously one of the groups in danger of social exclusion. Alcohol consumption is increasing in this group whilst it is decreasing in the other groups,” says Professor of Public Health Arja Rimpelä from the School of Health Sciences at the University of Tampere.

The correlation between depression – and other mental health problems – and socio-economic issues goes two ways. A lower socio-economic position is a burden which predisposes one to mental health disorders. At the same time, mental health disorders cause one’s social position to decline making it harder for the patients to get ahead in life. Parents suffering from mental health problems may not be able to support their children as much as they should, and the adolescents’ own mental health problems make it harder for them to concentrate on school work.

The problems often start at the lower secondary school.

 “At the lower secondary school age of 13-15 years, adolescents need to make a whole lot of choices at the same time as they are going through the developmental tasks of puberty. The class teacher they had in primary school is replaced by subject teachers, and the groups in which the pupils study change from one lesson to another. This is very challenging as the adolescents are expected to direct themselves and plan and make decisions about their future. If an adolescent is suffering from mental health problems or does not get the support he or she needs at home, the problems may start to accumulate,” says Professor of Adolescent Psychiatry Riittakerttu Kaltiala-Heino from the University of Tampere.

When the comprehensive school ends with the adolescents having completed compulsory education, their risk of being excluded from further education is great and may have far-reaching consequences.

“If adolescents drop out of school at this point, they will probably fare worse for the rest of their lives,” Kaltiala-Heino says.

The good news is that professionals are able to identify the risk groups of adolescents quite well these days. One can now benefit from large datasets, and an increasing number of longitudinal analyses are being conducted revealing correlations between the different paths the adolescents’ lives take. One tool is the nationwide School Health Promotion (SHP) study conducted every two years. The recent ones have combined the results from the Adolescent Health and Lifestyle Surveys in the 1980s and 1990s with present education registers and other socio-economic indicators, including mortality statistics. This information has helped to form a picture of how the socio-economic position of parents on one hand and the adolescents’ own behaviour on the other affect their later life, such as education in adulthood.

The first signs of who will be socially excluded and who will not emerge surprisingly early. A longitudinal analysis currently underway shows how the adolescents’ health behaviours even as early as twelve years predict whether they will choose to go to upper secondary school or vocational school or drop out of education altogether.

“About twelve years is the age when adolescents start to adopt unhealthy behaviours. That is also the age in which the adolescents’ paths start to differentiate,” Rimpelä remarks.

Smoking has an especially strong correlation with successful studies and the length of education. The pupils who educate themselves the longest smoke less in adolescence than those whose education is shorter. In the case of preteens, smoking may thus predict a shorter education.

Shorter education may also predict problems in later life.

“Education increases people’s potential to navigate in society and their freedom to make choices. If a young person remains uneducated, he or she will lack essential social capital that would be needed in life,” Kaltiala-Heino continues.

Smoking in itself is connected with many problems in health and well-being in later life. It is the most important singular risk factor for morbidity and mortality in adulthood.

Young people often get the example of smoking from their parents and even grandparents. Both Rimpelä and Kaltiala-Heino emphasise that the direction the adolescents’ life will take is not only determined on the basis of the parents’ lifestyle or socio-economic position; it is also a question of the young people’s own orientation to life, which is influenced by many factors.

School is one of the most central factors. That is why schools should pay attention to offering all pupils the opportunity to do well. Researchers are currently especially interested in the connection between schooling, i.e. learning, and well-being; such a study is currently ongoing in the Helsinki metropolitan area.

Researchers are also concerned about boys who develop more slowly than girls and may be excluded because of it. The regional polarisation of schools may also turn out to be problematic. Even though the differences between schools are smaller in Finland than they are globally, polarisation is already evident in the Helsinki area. Problems accumulate in the schools of some of the suburbs, and this is an issue people should react to.

“These schools should be allocated more than the usual resources,” Kaltiala-Heino suggests.

According to her, there is too much talk about how the clever and talented children “suffer in the worse schools”. Instead, we should be worried about the children who have worse starting points.

“Healthy and intelligent pupils will manage no matter where they are. They do not need to or should isolate themselves in some sort of a bubble as we all need to live in the same society. We should support those who have a harder time at school.”

Apart from school, support should be extended to families and homes and sooner rather than later. According to Kaltiala-Heino, families at risk should be helped from the moment their baby is born or preferably even before birth.

 “Services should be provided in homes. Child health clinics are in a key position because Finnish families frequently visit them. The clinics should identify the families’ problems, tackle them and offer active support,” Kaltiala-Heino continues.

International studies show that this type of support prevents a variety of problems from the mother’s depression and child abuse to adolescents’ conduct disorders.

But what happens when comprehensive school ends and adolescents do not have a clear plan of where to go next? Is all lost? According to Kaltiala-Heino, that is quite an alarming situation.

“If adolescents stay at home for three years playing computer games, it will be really hard for them to leave home later. During that time, their peers will have moved forward, and it may turn out to be impossible to catch up with them. That is why measures should be taken to prevent them from staying at home,” Kaltiala-Heino says.

She would raise the age in which compulsory education ends to seventeen years and change the definition of adult age from eighteen years to twenty-one.

“A 16- or an 18-year-old is simply not ready to make decisions that concern the rest of his or her life,” Kaltiala-Heino explains.

As a remedy, the government is now offering the Youth Guarantee whereby all pupils who finish comprehensive school are guaranteed education, a workplace or rehabilitation. According to Rimpelä, Youth Guarantee has had some positive effects.

“In the early 1990s, nearly ten per cent of all young people did not attend schools. Now the share of such youths is much smaller as nearly everyone has some education after comprehensive school and have attended further education for at least a short while,” Rimpelä says.

However, Youth Guarantee cannot help all because according to Kaltiala-Heino, its resources are too scarce.

“Youth Guarantee is an excellent thing in many ways but it is not efficient enough. I think it is unacceptable that an adolescent who is younger than eighteen can stay outside the scope of education and structured activities,” Kaltiala-Heino says.

According to the researchers, the significance of education for the young person’s later life cannot be overestimated.

“Education does not only provide access to better paid jobs but also general social capital and feelings of being in control as it offers the ability to understand society and increases feelings of inclusion. That is also important for mental and general health,” Kaltiala-Heino reminds.

It is a long way from the 1990s but some pitfalls still exist

The recession of the early 1990s weakened adolescents’ well-being and increased the different symptoms they experienced. The situation could be seen particularly clearly in the follow-ups on the well-being of young people and it gave cause to debate.

Since then, a number of solutions have been attempted. Among other things, health education has become a part of school curricula and statutes are now in place to regulate how school health care and pupils’ support should be organised.

This long-term trend is now abating and e.g. young people’s smoking and alcohol use are decreasing.

“This means that the society has reacted, and thanks to the excellent follow-up systems, we were able to discover the problems proactively,” Rimpelä says.

However, the future remains open.

“We do not know where the current developments and the latest cutbacks are taking us. Even though the well-being of young people has developed in the desired direction, some pitfalls still exist,” Rimpelä adds.

Text: Hanna Hyvärinen
Photograph: Jonne Renvall