School bullying and susceptibility to smoking among never-tried cigarette smoking students

Introduction: Bullying involvement has been linked with substance use; however, less is known about its relationship with pre-initiation stages of adolescent cigarette smoking behavior. This study examined the association between bullying involvement and smoking susceptibility among never tried or experimented with cigarette smoking students. Susceptibility to cigarette smoking in adolescence is a strong predictor of subsequent smoking initiation. Methods: A cross-sectional data on Canadian adolescent and youth were drawn from the 2012/2013 Youth Smoking Survey (n = 28,843). Logistic regression analysis was used to examine the association between bullying and smoking susceptibility among never-smoking students. Results: About 21% self-reported involvement in bullying (as a bully, victim or both). Middle school students (grades 6-8) reported more involvement in bullying (24%) than those in grades 9-12 (16%). The multivariable analyses showed that the association between bullying and smoking susceptibility was significantly different by grade level. Middle school students involved in bullying had higher odds of smoking susceptibility compared to uninvolved students (bully, adjusted odds ratio [AOR] = 2.54, 95% CI = 1.73-3.74; victim, AOR = 1.29, 95% CI = 1.11-1.48; bully-victim, AOR = 2.19, 95% CI = 1.75-2.74). There were no significant associations between all subgroups of bullying and smoking susceptibility for grades 9-12 students. Conclusions: Students involved in bullying were more susceptible to smoking, although patterns of association varied by grade level. In particular, the findings highlight that non-smoking middle school students involved in bullying were susceptible to future smoking.