Arja Rimpela

Tampere University | UTA · Faculty of Social Sciences, Unit of Health Sciences

Introduction Longitudinal studies investigating lifestyle factors as risk factors for high-energy traumas from adolescence to adulthood are lacking. The aim of this study was to investigate the influence of 14 to 18-year old adolescent health-related behaviours, overweight, chronic disease, family socioeconomic status (SES), and adulthood education...

Background Lower socioeconomic positions (SEP) and poor academic achievement increase children’s risk for mental health problems. The Finnish education system is officially non-selective and unified, but a part of children can be selected into emphasised teaching classes by aptitude tests, which are known to segregate students by SEP and academic a...

Study Design Retrospective longitudinal study Objective This study aims to investigate the influence of adolescent health-related behaviors (physical activity, high BMI, drunkenness, smoking), self-reported chronic disease, and low socioeconomic status (SES) on the development of low back pain requiring hospitalization or surgery. Summary of Back...

Background: The origin of inequalities in health outcomes has been explained by health selection and social causation models. Health selection processes operate particularly at school age. We study, if student allocation to teaching groups with aptitude tests (selective vs general class) differentiates adolescents by health behaviors and mental he...

Background The positive association of health with education level and socioeconomic status (SES) is well-established. Two theoretical frameworks have been delineated to understand main mechanisms leading to socioeconomic health inequalities: social causation and health selection but how these work in adolescence is poorly known. We studied if adol...

Based on survey data collected from 2159 teachers, multilevel structural equation modelling was applied to explore associations between collective teacher efficacy, teachers' perceptions about the school's preparedness to confront school closure in the future and work-related stress in the teacher community during the COVID-19 pandemic. Higher leve...

Background Since the start of the COVID-19 pandemic, several studies have shown deterioration of adolescents’ mental health when comparing periods before and after the start of the pandemic when there were national school closures. Less is known of the following waves with more variation in school closures and their duration. We study here, if vari...

Artikkelissa tarkastellaan painotetun opetuksen mukaisen oppilasryhmittelyn yhteyttä kuudennen luokan oppilaiden osaamiseen sekä kouluintoon ja koulu-uupumukseen. Tutkimuksessa käytettiin Turussa kerättyä aineistoa kuudennen luokan oppilaiden (N = 876) vastauksista kysely- ja tehtäväpakettiin. Oppilaat tulivat 22 alakoulusta, yhteensä 49 luokalta,...

Online health information-seeking behaviour has increased since the World Health Organization declared COVID-19 a global pandemic in March 2020. This study examined whether health-related information on COVID-19 searched on the internet was associated with mental well-being among higher education students. A cross-sectional internet survey was cond...

Chronic disease may affect adolescents’ educational success. We study whether adolescents with a somatic chronic condition have lower school performance, lower odds for academic education, and a delayed start of upper-secondary studies. Seventh graders and ninth graders in the Helsinki Metropolitan Region, Finland, were invited to participate in a...

Background School staff members’ consistent enforcement of school tobacco policies (STPs) is needed to decrease adolescent smoking and exposure to tobacco smoke. Staff’s confidence, indicating their perceived ability to cope with students’ negative responses, explains variations in staff’s STPs enforcement, yet understanding of the determinants for...

Aims Europe’s Beating Cancer Plan set a goal of creating a Tobacco-Free Generation in Europe by 2040. Prevention is important for achieving this goal. We compare the Nordic countries’ preventive tobacco policies, discuss the possible determinants for similarities and differences in policy implementation, and provide strategies for strengthening tob...

Finnish students start academic or vocational track in upper secondary education at age 16 years. Track placement is based on grades, but family background and psychosocial resources may have influences. Using 2014 survey data of Grade 9 students in Helsinki Metropolitan area linked to the Joint Application Registry data as of 2017, we fitted two-l...

During the recent years, new tobacco and tobacco-like products, e.g., e-cigarettes, have emerged on the market. Adolescents often underestimate health risks in general, including those concerning tobacco. Little is known of adolescents’ perceptions of health risks of the newer products. Our paper compares adolescents’ perceptions of harmfulness of...

New tobacco and nicotine products have emerged on the market in recent years. Most research has concerned only one product at a time, usually e-cigarettes, while little is known about the multiple use of tobacco and nicotine products among adolescents. We examined single, dual, and triple use of cigarettes, e-cigarettes, and snus among Nordic adole...

Background: To address social inequalities in adolescent substance use and consequent disparities in health, it is important to identify the mechanisms of the association between substance use and academic performance. We study the role of health literacy (HL) in the association between academic performance and weekly smoking, monthly alcohol use...

Engaging parents in school health examinations can promote adolescents’ well-being. We examined parents’ participation in universal school health examinations in Finland reported by adolescents in school surveys (14 to 16-year-olds, N = 58,232). Further we studied variation between service providers and schools, and student and school-level factors...

The COVID-19 pandemic enforced countries to close schools and rapidly transfer to distance teaching without preparation. Little is known about how different distance teaching practices influenced students’ wellbeing. We studied this during the period of school closures in Finland. Wellbeing was measured by health complaints and perceived loneliness...

Background During the COVID-19 pandemic, Internet and social media became important and fast sources of health information, leading to overabundance of both valid and invalid information. Digital health literacy (DHL) is a core competency for navigating web- and social media based COVID-19 information. This study is part of the global COVID-HL surv...

Introduction European estimates of adolescent smoking cessation are lacking and studies on the role of schools in quit behaviour are scarce. We aimed to describe smoking cessation attempts and success among adolescents in Europe and explored the association with school policy and programmes. Methods We used cross-sectional data from the 2013 and 2...

Background The relationship between socioeconomic position (SEP) and adolescent physical activity is uncertain, as most evidence is limited to specific settings and a restricted number of SEP indicators. This study aimed to assess the magnitude of socioeconomic differences in adolescent vigorous physical activity (VPA) across various European count...

Background Studies on adolescent secondhand smoke exposure within the family often dichotomously operationalize migration background without paying attention to social and cultural diversity within migrant populations. As a result, little is known about variation within migrant groups in smoke-free family environments (SFFEs). This study analyses...

Background and aim Bereavement affects the health of the bereaved both emotionally and physically. Bereavement resulting from alcohol-related death of the previous generation (parents-first generation) may increase the risk of alcohol abuse and consequently alcohol-related mortality as well as all-cause mortality in the next generation (offspring-s...

Background: Studies comparing adolescent e-cigarette use in different countries are scarce. We study students' e-cigarette and conventional cigarette ever-use, their social correlates and e-liquid use in seven EU countries. Methods: SILNE-R data (N=12 167, response rate 79.4%) of 14-17-year-olds from Amersfoort (NL), Coimbra (PT), Dublin (IR), H...

Background Adolescents' images of the future emerge from knowledge built on experiences of the past and present and their age-related developmental tasks. Images of the future direct adolescents' decision-making, choices, and behavior. The images of the future can act as a mirror of our times, reflecting the political values and ethos of society. T...

Background Educational inequalities occur when differences in educational outcomes are more strongly related to students' background than their own academic efforts. During adolescence, psychosocial resources such as social support and self-efficacy, collectively termed “reserve capacity” may serve as a pathway to educational transitions and help r...

Background Serious long-term diseases like asthma, diabetes or epilepsy in adolescence means extra efforts to cope everyday life in school, hobbies or at home. These also set extra challenges on adolescents to go through the developmental tasks of that age. We study here, if adolescents with a long-term disease have lower chances for an academic ed...

The increasing denormalization of smoking by tobacco control policies and a normative smoke-free climate may shift power towards adolescent non-smokers. It is unclear, however, how common stigmatization of smokers is among adolescents or how stigmatization relates to the denormalization of smoking in their school and social environment. This paper...

Existing literature on recent trends in adolescent gambling is scarce. The rapidly changing landscape of gambling, together with the generally applied legal age limits, calls for the continuous monitoring of gambling also among the adolescent population. In Finland, the legal gambling age is 18. We examined changes in adolescents’ gambling, gamblin...

The long-term effects of sleep on adolescent psychosocial well-being are mostly unknown, although insufficient sleep has been associated with emotional and behavioral difficulties in cross-sectional studies. With a five-year follow-up of Finnish adolescents (Time 1: n = 8834; Mean age = 13 years, 51.1% female, Time 2: n = 5315, Mean age = 15 years,...

Assessment of the effectiveness of school tobacco policies (STPs) in reducing adolescent smoking remains inconclusive. Previous studies took insufficient account of different dimensions of STPs, the different views of students and staff, and policy changes over time. This study assessed how a multidimensional STP, as perceived by students and staff...

Peer networks at school and students’ position in these networks can influence their academic well-being. We study here individual students’ network position (isolation, popularity, social activity) and peer network structures at the school level (centralization, density, clustering, school connectedness) and their relations to students’ academic w...

Accumulated disadvantage (AD) is conceptualised here as an agglomeration of unfavourable or prejudicial conditions which in adolescence may compromise the progress to further education or future life chances. There are several theories on AD, suggesting, e.g., (1) an increase of AD by age and (2) trajectories (previous disadvantage predicts later d...

Background Advocacy, resources and intersubjective reasonable arguments are known as factors that contribute to smoke-free (SF) adoption and implementation in Chinese and Anglo-Saxon places. Less is known about how the implementation of smoking bans differs across European places. The aim of this qualitative comparative study is to identify and cl...

Background: Many European schools implement smoke-free school policies (SFSPs). SFSPs may decrease adolescent smoking by causing adolescents to perceive stronger anti-smoking norms, yet there exists no quantitative evidence that indicates for which norms and for whom such effects may occur. This study therefore assessed to what extent adolescents'...

Background: The health selection hypothesis suggests that poor health leads to low educational attainment during the life course. Adolescence is an important period as poor health might prevent students from making the best educational choices. We test if health in adolescence is associated with educational aspirations and whether these associatio...

Background Secondhand smoke exposure is responsible for over half a million premature deaths. With regulation now reducing smoking in most public enclosed spaces, one major source of indoor exposure remains the home environment. Home smoking bans (HSBs) are household rules that restrict smoking from certain (partial HSB) or all areas (complete HSB)...

Background Adolescents’ alcohol use and binge drinking decreased in Finland since 2001 while the proportion of those who did not drink, increased until 2017. The 2018 Alcohol Act (entered 1 March) allowed retail stores sell all alcoholic beverages containing up to 5.5% alcohol by volume (previously 4.7%, beer and cider). Alcopops, assumed popular a...

Background We studied the associations of health-compromising behaviours with a transition into secondary education by following a large cohort of Finnish adolescents. Students with a direct (successful) transition into secondary education after the 9th grade (73%) and those with a late transition (7%) were compared. Methods We analysed the follow...

Background Beliefs about smoking have been found to be associated with smoking behaviour. Similarly, health literacy (HL) as a competence to make health-related decisions has been identified as an independent factor to explain differences in smoking. However, little is known about adolescents’ HL in different countries, and how HL is associated wit...

Background: The Finnish government has emphasized the need to expedite educational transitions. We study if a late start of upper secondary education is related to health-related selection, namely health-compromising behaviours in adolescence. Methods: A large cohort of adolescents from the seventh (12-13 years) and ninth (15-16 years) grades an...

This study aimed to assess where European adolescents smoke. Data of 2,140 13-19-year-olds from 55 secondary schools in seven European cities was analysed using multilevel logistic regression analyses. Adolescents most often reported regularly smoking in 'other public locations (e.g., streets and parks)' (69%) and friends' homes (50%). Adolescents...

Background: Tobacco-control policies have been suggested to reduce smoking among adolescents. However, there is limited evidence on the real-world costs of implementation in different settings. In this study, we aimed at estimating the costs of school smoking bans, school prevention programmes and non-school bans (smoking bans in non-educational p...

This study focused on the prevalence of cyberbullying dimensions (victims, bullies, seriousness of cyberbullying encountered) and its association with perceived health of Finnish adolescents. A representative data sample of 12, 14, 16 and 18-year-old Finns from the Adolescent Health and Lifestyle Survey (AHLS) of the year 2015 were used. Participan...

Background Smoke-free school policies (SFSPs) may influence adolescents’ smoking through the development of anti-smoking beliefs. We assessed which types of anti-smoking beliefs (health, social and societal) are associated with SFSPs and whether these associations were different for adolescents in smoking permissive versus prohibitive families. M...

Introduction Economic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (non-school bans, including bans on s...

Background: School tobacco policies (STPs) that aim to achieve a tobacco-free environment require consistent enforcement by school staff. However, little is known about why staff choose whether or not to enforce STPs. Therefore, we investigated staff members' responses to STPs that determine enforcement. Furthermore, we examined how these response...

Background Although there is evidence for socioeconomic inequalities in health and health behaviour in adolescents, different indicators of socioeconomic status (SES) have rarely been compared within one data sample. We examined associations of five SES indicators with self-rated health (SRH) and smoking (ie, a leading cause of health inequalities)...

Background: Several studies indicate an association between e-cigarette use and subsequent smoking among youth. However, most previous studies lack measures of the nicotine content of e-liquid and have not usually measured regular smoking. Methods: We tested the association between e-cigarette use, with and without nicotine, and subsequent daily...

Objectives Finland boldly legislated the end of tobacco use in its 2010 Tobacco Act, and subsequently expanded the goal in 2016 to eradicate other nicotine-containing products. This study explored stakeholders’ perceptions about the strengths, barriers, solutions and rationale for Finland’s comprehensive but conventional strategy to achieve its nic...

Introduction Finland’s success in achieving the goal of its tobacco endgame largely depends on rectifying deficiencies in the delivery of smoking cessation services. One such weakness, which has not been documented with empirical data, is misuse of nicotine replacement therapy (NRT). This study’s objective was to examine purchase patterns of NRT fo...

Background. Family socioeconomic status (SES) is related to a child´s educational success. Intermediate pathways for this relationship, such as through pubertal timing and reserve capacity, occur in adolescence. Aim. To study whether family SES affects a child’s adult education through a psychosocial and behavioural pathway (reserve capacity) and/o...

The poster provides information on how survival analysis methodology was applied to determine the effects of family socioeconomic status, reserve capacity and school achievement in adolescence on later mortality.

Aim: We studied how multigenerational socioeconomic circumstances influence adolescents’ smoking. Previous studies have shown that low academic achievement as well as parents’ low socioeconomic circumstances are associated with adolescents’ smoking, but there are few studies on grandparents’ influence on their grandchildren’s smoking. For the chain...

Introduction Finland implemented a point-of-sale (POS) display ban for tobacco products and their trademarks in 2012, and for electronic cigarettes in 2016. In this study we examine whether noticing tobacco products changed among adolescents after the implementation of the display ban and describe the noticing of e-cigarette displays post-implement...

Continual conduct problems from adolescence to adulthood comprise a societal concern. Knowledge of school-related triggers and contributors to persistent conduct problems is important but still limited. We explored the role of schoolwork difficulties and being bullied by peers at school in the development of conduct problems, controlling for vulner...

This study investigates whether class-level school performance affects students’ life satisfaction and if there are differential effects for high- and low-performing students. Data were derived from the National Educational Panel Study, including n = 5196 students (49.6% girls), nested in 478 classes and 250 secondary schools. School performance in...

Background: Youth unemployment is a critical life event, which may trigger other labour market-related disadvantages and detrimental health implications. To better understand the processes causing unemployment, we study how socioeconomic circumstances of successive generations and familial and health factors in adolescence predict youth unemployme...

BACKGROUND We studied school‐level differences in academic achievement and well‐being from 2002 to 2010 in the Helsinki Metropolitan Area, as well as the connection between academic achievement, well‐being, and socioeconomic composition. METHODS The School Health Promotion Study covered 109 schools and 78% of schoolchildren (N = 100,413; aged 14 t...

Abstract Background Previous research suggests that parental knowledge of the child’s activities and whereabouts prevents adolescents’ alcohol use. However, evidence on whether the positive effects of maternal and paternal knowledge are distinctive for boys’ and girls’ alcohol use is inconclusive. We examined whether perceived parental knowledge at...

Universal school health services are expected to offer similar, needs‐based services to all students across schools, service providers and students’ socio‐economic statuses and health needs. This study investigates access to school health nurses in Finland. The objectives were to study the differences in access to school health nurse between servic...

Background: Low academic achievement has been associated with smoking but factors behind this association are poorly known. Such factors could include schoolwork disengagement and schoolwork difficulties. To assess the extent to which they contribute to the explanation of how health inequalities emerge, we study in a longitudinal design whether th...

Due to increasing immigration, a growing number of Finnish youths or their parents are immigrants. It is therefore more important than ever to study the psychosocial well-being of immigrant background youths but, so far, studies on this topic are scarce. Our aim was to study whether the psychosocial problems reported by immigrant background youths...

The effect of students’ psychosocial problems on their reporting of indoor air quality (subjective IAQ) and indoor air-related (IA-related) symptoms has not been studied in schools in a longitudinal setting. Therefore, we analyzed whether changes in students’ psychosocial problems (socioemotional difficulties and perceived teacher–student relations...

Background Schools are crucial settings for young people’s development. Rare studies have examined the impact of perceived school-climate and academic well-being on young people’s self-rated health in joint analyses. This study focuses on the role of perceived school-climate and academic well-being for young people’s self-rated health and examines...

Poor academic performance is a known risk factor for adolescent smoking, yet the association remains unclear, as the role of social ties has been rarely examined. Our study aims to investigate the role of friendship ties in this association. In a sample of 11,015 adolescents, aged 14 to17, in 50 schools within six European cities (SILNE-survey, 201...

Kouluterveydenhuollon tulee olla suunnitelmallista, laadukasta ja tasoltaan yhtenäistä. Vuonna 2009 annettu asetus velvoittaa kuntia tekemään yhtenäisen toimintaohjelman lasten ja nuorten ehkäiseville terveyspalveluille. Tutkimuksessa arvioidaan kouluterveydenhuollon suunnitelmallisuutta ja yhtenäistä tasoa toimintaohjelmien avulla. Vertailukelpois...

Background: The purpose of this study was to investigate the prevalence of adolescent physical activity-related injuries in sports club activities, leisure time physical activity and school-based physical activity. The secondary aim was to investigate the differences in the prevalence of physical activity -related injuries between years 2014 and 2...

Little is known of the predictors of electronic cigarette (e-cigarette) use among adolescents, even though the use is increasing. We studied here the predictors for e-cigarette experimentation (tried and tried more than twice) and compared them with predictors for conventional smoking. A baseline school survey was conducted in the Helsinki metropol...