Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS): smoking report 2018

1 Introduction and background

This report presents the smoking and e-cigarette findings from the 2018 wave of the Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS). The research was commissioned by the Scottish Government and carried out by Ipsos MORI Scotland.

Survey background

SALSUS is a continuation of a long established series of national surveys on smoking, drinking and drug use. These were carried out jointly in Scotland and England between 1982 and 2000, to provide a national picture of young peoples' smoking (from 1982), drinking (from 1990), and drug use (from 1998) within the context of other lifestyle, health and social factors. Since 2002, Scotland has developed its own, more tailored survey known as SALSUS. 

Survey purpose

SALSUS informs progress towards Scottish Government policies to reduce the harms from smoking, drinking and drug use among children and young people.

The survey series also provides local prevalence rates for smoking, drinking and drug use across Alcohol and Drug Partnerships (ADPs), local authorities and NHS Boards.

Policy background

Though in decline, smoking remains the main preventable cause of ill-health and premature death in Scotland. 

The Scottish Government has taken various policy actions to reduce the use of, and harm caused by, tobacco. This is one of Scotland’s six public health priorities^[2] (along with reducing harms from alcohol and drug use). 

Since the Scottish Parliament was established in 1999, it has overseen a range of measures aimed at reducing smoking including:

• legislation to ban tobacco advertising (2002)
• a ban on smoking in public places (2006) 
• an increase in the age for tobacco sales from 16 to 18 (2007)
• the overhaul of tobacco sale and display law, including banning the display of cigarettes in shops and banning sales from vending machines (2010)
• awareness raising campaigns
• continued investment in NHS stop smoking services
• further control of tobacco and e-cigarettes in the 2016 Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill
• introducing new rules for the purchase and supply of vapour products in 2017
• making prisons smoke-free from November 2018.

In 2013, the Scottish Government published a tobacco control strategy^[3] and set a target of creating a tobacco-free generation by 2034. In 2018, the Scottish Government published its tobacco control action plan^[4] which emphasises prevention through informing and empowering people to make healthier decisions, raising awareness on the dangers of smoking and encouraging healthier behaviours. It also details strategies to improve services and restrict the supply of/demand for tobacco.

Policies that will come into effect in the near future include:

• banning smoking around hospital buildings in 2020
• regulating the sale of electronic cigarettes or nicotine vapour products (NVPs)
• promoting a new national brand - Quit Your Way - for the stop-smoking service which was launched in 2018
• using the Scottish Ministerial Working Group on Tobacco Control to help develop policy to reduce the impact of tobacco on Scotland's health
• managing the Register of Tobacco and NVP retailers

Further information about policy relating to smoking is available at:

• NHS Health Scotland:  http://www.healthscotland.scot/health-topics/smoking/smoking-prevention
• Scottish Government: https://www.gov.scot/policies/smoking/

Methods

SALSUS is a self-completion survey administered by teachers in a mixed ability class, under exam conditions. In the past the survey has been completed on paper, but in 2018 schools were given the choice to complete the survey online or on paper. 

A random, nationally representative sample of S2 and S4 pupils in Scottish schools was drawn with classes as the primary sampling unit. All local authority and independent schools in Scotland were eligible for inclusion in the sample, with the exception of special schools. 

Fieldwork was completed between October 2018 and April 2019. A total of 12,558 S2 and 10,807 S4 pupils responded (including schools that took part in the Realigning Children’s Service Survey). 

The overall response rate was 52% (excludes schools that took part in the Realigning Children’s Services Survey and Glasgow state schools).

Data was weighted by local authority, age, sex, school sector (state/independent), school denomination and by urban/rural classification.

Throughout the report pupils in S2 are referred to as ‘13 year olds’ and S4 pupils are referred to as ‘15 year olds’ for ease. It should be borne in mind that some pupils within these categories may be slightly older or younger. 

Some pupils did not answer each question. Where answers are missing, these have been excluded from the analysis and so charts and tables that describe the same population may have varying bases. When differences between estimates are specifically commented on in the report, these differences are statistically significant to the level of 0.05.

Percentages may not add up to 100% due to rounding.

For full details of the methodology, please see the SALSUS 2018 Technical Report^[5]. 

Finally, it is important to note, that while there are associations between many of the behaviours explored in this report, conclusions about causality cannot be drawn.

Changes to the questionnaire

No alterations were made to the tobacco questions for 2018, so they are the same as in the 2015 survey. For further details on other question changes and survey methodology see the SALSUS 2018 Technical Report and the full 2018 questionnaire^[6].