Short report Social capital and adolescent smoking in schools and communities: A cross-classified multilevel analysis Bart De Clercq a, * , Timo-Kolja Pfoertner b , Frank J. Elgar c , Anne Hublet a , Lea Maes a a Ghent University e Faculty of Medicine and Health Sciences, Department of Public Health, Academical Hospital, K3-4, De Pintelaan, 185, B-9000 Gent, Belgium b Institute of Medical Sociology, Martin Luther University, Halle (Saale), Germany c Institute for Health and Social Policy and Douglas Institute, McGill University, Montreal, Quebec, Canada article info Article history: Received 8 April 2014 Received in revised form 12 August 2014 Accepted 14 August 2014 Available online 15 August 2014 Keywords: Adolescence Smoking Social capital Inequalities Cross-classified multilevel models abstract We sought to determine whether social capital at the individual-, school- and community-level can explain variance in adolescent smoking and accounts for social inequalities in smoking. We collected data as part of the 2005/6 Health Behavior in School-aged Children survey, a nationally representative survey of the health and well-being of high school pupils in Belgium (Flanders). Social capital was assessed by structural and cognitive components of family social capital, a four-factor school social capital scale and a cognitive community social capital scale. We fitted non-hierarchical multilevel models to the data, with 8453 adolescents nested within a cross-classification of 167 schools and 570 com- munities. Significant variation in adolescent regular smoking was found between schools, but not be- tween communities. Only structural family social capital and cognitive school social capital variables negatively related to regular smoking. No interactions between socio-economic status and social capital variables were found. Our findings suggest that previously observed community-level associations with adolescent smoking may be a consequence of unmeasured confounding. Distinguishing nested contexts of social capital is important because their associations with smoking differ. © 2014 Elsevier Ltd. All rights reserved. 1. Introduction Tobacco smoking, the largest single cause of avoidable death in the EU (European Commission, 2013), inversely relates to socio- economic status in adult (Winkleby et al., 1992) and adolescent populations (Blane et al., 1996). Prevention interventions are needed at an early stage because such health-risk behaviors are typically established during adolescence and young adulthood (Centers for Disease Control and Prevention, 2008). The last twenty years have witnessed an explosion of interest in place effects on health (Diez Roux, 1998; Macintyre et al., 2002). This research has found between-school and between-neighborhood variance in adolescent smoking (Aveyard et al., 2005; Henderson et al., 2008; Kelly et al., 2011; Lovato et al., 2010). However, differences in the associations of social contextual factors with the prevalence of smoking remain unclear (Galea et al., 2004). The goal of this study was to explore the social context of adolescent smoking. The association between social capital and adult smoking is well documented (Chuang and Chuang, 2008) including the “miniatur- ization of community” phenomenon (Lindstrom, 2003), but evi- dence in adolescent populations remains sparse. Few studies have examined a link between both individual- (Curran, 2007; Lundborg, 2005; Morgan and Haglund, 2009) or contextual social capital (Aslund and Nilsson, 2013; Henderson et al., 2008; Takakura, 2011; Thorlindsson et al., 2012) and adolescent smok- ing, and more specifically in the context of families (Curran, 2007), schools (Henderson et al., 2008; Takakura, 2011), and communities (Aslund and Nilsson, 2013; Thorlindsson et al., 2012). The definition and measurement of social capital are important to understand (a) the heterogeneous findings across studies, and (b) the differential impact of various components of social capital on health. Social capital has been broadly defined as the resources that individuals access through their social networks (Kawachi and Berkman, 2001). A first distinction in the conceptualization and measurement of social capital is commonly drawn between “structural” and “cognitive” components of social capital (Harpham et al., 2002). The structural component reflects behavioral manifestations of network connections: network social capital refers to network * Corresponding author. E-mail address: b.declercq@ugent.be (B. De Clercq). Contents lists available at ScienceDirect Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed http://dx.doi.org/10.1016/j.socscimed.2014.08.018 0277-9536/© 2014 Elsevier Ltd. All rights reserved. Social Science & Medicine 119 (2014) 81e87