Adolescent health literacy in 3 European cities and its association with smoking and smoking beliefs

Abstract 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 with health behaviour and health-related beliefs. The aim of this study is to describe the levels of HL in three European cities, and how HL is associated with smoking and beliefs about smoking consequences. Methods In 2016 as part of SILNE-R study, 5,088 adolescents aged 14 to 16 years answered a school survey in Amersfoort (NL), Hanover (G…