School differences in pupil smoking: a consequence of a trade-off between health and education agendas?

Current policy documents stress that raising standards in education and health are inextricably linked, with schools identified as well placed to advance both agendas. This paper considers these assumptions in the light of data derived from 27 staff interviews conducted in two secondary schools. These schools served relatively disadvantaged communities, but differed in their pupil smoking rates with one school being 'high-smoking', the other 'low-smoking'. It explores whether this difference reflects the differential emphasis placed by each school on education or health. Analysis reveals that the 'low-smoking' school subscribes to holistic values and operates according to a child-centred bottom-up philosophy offering a differentiated programme of pupil support contingent on needs. In contrast, the 'high-smoking' school maintains a narrow focus on educational outcomes, and its high expectations are viewed as running counter to those held by pupils and parents. The contrasting school philosophies bring different unintended consequences. The holistic focus of the low-smoking school is associated with tempered educational expectations, thus conflicting with recommendations in education policies. The singular education focus of the high-smoking school leaves little room for a health agenda, and can overlook and disenfranchise the educationally disinclined. The school systems' impact on pupil engagement may explain their different smoking rates.