Adolescent smoking heavily influenced by parents and siblings

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1. Children of persistent smokers were much more likely to have smoked in the past year than children of non-smokers. 

2. Adolescents who have an older sibling that smokes were much more likely to have also smoked in the past year.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Adolescent smoking is influenced by both genetic and environmental factors, of which parental smoking behaviors play a large role. This multigenerational, longitudinal study provides prospective measures of the intensity of parental smoking and their adolescent children’s subsequent risk of smoking. Results from this study indicate that children of persistent smokers were much more likely to have smoked in the past year than children of non-smokers. Furthermore, adolescents are strongly influenced by their older siblings: those with an older sibling who smoked were 6 times more likely to have also smoked in the past year. Younger children and those with higher GPA scores were less likely to have smoked. Limitations include selection bias and smoking information obtained from one parent only. Nonetheless, parents should be made aware of the effects of their smoking behavior on their children’s cigarette use, with intervention efforts targeting both the parent and child.

Click to read the study published today in Pediatrics

Relevant Reading: How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General

Study Author, Dr. Michael Vuolo, PhD, talks to 2 Minute Medicine: Purdue University, Assistant Professor, Department of Sociology; Faculty Associate, Center on Aging and the Life Course

“By using parent smoking data from when they were freshmen in high school through to age 38, our study more firmly establishes the link between parental smoking and child smoking. For clinicians, we should advise young people that no amount of smoking is a good decision, though here emphasizing not only for their own health, but for the health of their (future) children. All parental smoking patterns, whether heavy/light or early/late onset, result in higher child smoking rates relative to consistent nonsmokers. Having information on the entire household also allowed for a unique look at the influence of siblings. Heavy, persistent smoking parents highly increase the odds of older sibling smoking, who then influence the chances of younger sibling smoking. Thus, we should also target older siblings who smoke, advising them that their behavior influences their young siblings’ smoking.”

In-Depth [prospective cohort study]: 214 parents and their 314 children were surveyed multiple times between 1988-2011. Children who smoked in the past year (16%) were older (16.9 vs. 14.3 years), had higher depressive affect (13.8 vs. 11.2), lower GPA (2.40 vs. 3.07), and self-esteem scores (8.8 vs. 9.5) than those who did not smoke (p < .05 for all comparisons listed). Significantly more smokers than nonsmokers reported feeling “not at all” close to their parents (31.8%); smokers were also more likely to have an older sibling who smoked (OR = 6.3). Stable, nonsmoker parents had the lowest percentage (8%) of children who smoked and adolescents of married parents had the lowest levels of smoking. Early-onset light smokers, early-onset heavy smokers, and late-onset smokers were significantly more likely (OR = 3.2, 3.8, and 4.6, respectively) to have children who smoked than stable, nonsmoker parents. Early-onset heavy smokers were particularly likely to have both an adolescent smoker and an older child who smoked in the past year (OR = 15.4, p < .001).

By Cordelia Y. Ross and Leah H. Carr

More from this author: Autistic boys spend more time playing video games; Parents’ TV viewing time is strongly associated with child viewing time; Half of parents aware of CT radiation cancer risk; Pediatric chronic pain patients typically Caucasian, female adolescents; Previous concussion linked to prolonged symptoms following second concussion

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