Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control.
OBJECTIVE
Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relationship between parental smoking and the risk of smoking initiation during adolescence. This study investigates unresolved issues concerning the strength and nature of the association between parent smoking and offspring smoking initiation.


METHODS
We enrolled 564 adolescents aged 12 to 17, along with 1 of their parents, into the New England Family Study between 2001 and 2004. Lifetime smoking histories were obtained from parents and their adolescent offspring. Discrete-time survival analysis was used to investigate the influence of parental smoking histories on the risk of adolescent smoking initiation.


RESULTS
Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring. In addition, the likelihood of offspring smoking initiation increased with the number of smoking parents and the duration of exposure to parental smoking, suggesting a dose-response relationship between parental smoking and offspring smoking. Offspring of parents who had quit smoking were no more likely to smoke than offspring of parents who had never smoked. The effects of parental smoking on offspring initiation differed by sex (with a stronger effect of fathers' smoking on boys than girls), developmental period (with a stronger effect of parental smoking before the adolescent was age 13 than afterward), and residence of parents (with effects of fathers' smoking being dependent on living in the same household as the adolescent). Parental smoking was also associated with stronger negative reactions to adolescents' first cigarette, a potential marker of the risk of progression to higher levels of use.


CONCLUSIONS
Parental smoking is an important source of vulnerability to smoking initiation among adolescents, and parental smoking cessation might attenuate this vulnerability.
Gilman
Stephen E
SE
Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. sgilman@hsph.harvard.edu
Rende
Richard
R
Boergers
Julie
J
Abrams
David B
DB
Buka
Stephen L
SL
Clark
Melissa A
MA
Colby
Suzanne M
SM
Hitsman
Brian
B
Kazura
Alessandra N
AN
Lipsitt
Lewis P
LP
Lloyd-Richardson
Elizabeth E
EE
Rogers
Michelle L
ML
Stanton
Cassandra A
CA
Stroud
Laura R
LR
Niaura
Raymond S
RS
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D016019:Survival Analysis