[School performance as a mediator of the association between family affluence and risk behaviour in adolescents in Poland].

Unlabelled: It can be assumed that family socioeconomic status does affect the frequency of undertaking risk behaviours by adolescents directly or indirectly, i.e. by having impact on other proven risk factors. The objective of the study was to show the combined influence of family affluence and school performance on alcohol consumption and tobacco and marijuana smoking, defined as risk behaviour syndrome.

Material And Methods: The survey was conducted on a nationwide sample of 1,202 adolescents aged on average 15.6 years (SD=0.31), who participated in the HBSC (Health Behaviour in School-aged Children) survey. Structural equation models were used in the analysis in order to test the hypothesis that school performance is a mediator of the association between family affluence and risk behaviour.

Results: It was found that 23.0% of adolescents smoked tobacco; 40.8% drank alcohol; 10.2% smoked marijuana. One fifth of the respondents used one of those substances frequently, i.e. more than 5 days in the last month. It was shown that family affluence is strongly correlated with school performance (p<0.001), however, there was no direct relationship with the general level of psychoactive substance use (p=0.481). In analysing individual substances, only with regard to marijuana it was found that it was used less frequently in more affluent families. School performance resulted to be a stronger mediator of the relationship between family affluence and risk behaviour in girls (Sobel’s test: p=0.013) than in boys (p=0.111). In the analysis of the social determinants of the health behaviour of adolescents, indirect correlations and confounding variables should be considered. Worse school performance may be the cause or effect of a more frequent psychoactive substance.