Socio-economic inequalities in smoking and drinking in adolescence: Assessment of social network dynamics

Addiction. 2024 Mar;119(3):488-498. doi: 10.1111/add.16384. Epub 2023 Nov 22.

Abstract

Aims: We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups.

Design: This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves.

Setting: Eight Hungarian secondary schools with socio-economically diverse classes took part.

Participants: This study comprised 232 adolescents aged between 14 and 15 years in the first wave.

Measurements: Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit.

Findings: Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.02-1.11]. Adolescents adjusted their smoking behavior (OR = 24.05, 95% CI = 1.27-454.86) but not their alcohol consumption (OR = 1.65, 95% CI = 0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 0.98, 95% CI = 0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.16, 95% CI = 1.01-1.33), but this association was not significantly different according to SES.

Conclusions: Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.

Keywords: Adolescents; alcohol; health inequalities; peers; smoking; social influence; social network; social selection; stochastic actor-oriented models.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Alcohol Drinking / epidemiology
  • Child
  • Friends
  • Humans
  • Longitudinal Studies
  • Smoking* / epidemiology
  • Social Class
  • Social Networking
  • Socioeconomic Factors
  • Tobacco Smoking