title: Smoking Initiation Among Mexican Heritage Youth and the Roles of Family Cohesion and Conflict.
abstract: OBJECTIVE
  High levels of family conflict increase the risk for early smoking initiation and smoking escalation among adolescents, whereas high levels of warmth and cohesion in the family are protective against smoking initiation. However, little is known about the associations between changes in family function during adolescence on subsequent smoking initiation among Mexican heritage adolescents.
  
  
  METHODS
  In 2005-2006, 1,328 Mexican heritage adolescents aged 11-14 years enrolled in a cohort study to examine nongenetic and genetic factors associated with cigarette experimentation. In 2008-2009, 1,154 participants completed a follow-up. Multivariate logistic regression models were computed to prospectively examine associations between smoking behavior assessed in 2008-2009 and changes in family cohesion and family conflict assessed in both 2005-2006 and 2008-2009, controlling for gender, age, and linguistic acculturation, positive outcome expectations associated with smoking, as well as friends and family smoking behavior.
  
  
  RESULTS
  Overall 21% had tried cigarettes by 2008-2009. Consistently low levels of family cohesion (odds ratio [OR] = 3.06; 95% confidence interval [CI], 1.38-6.73) and decreases in family cohesion (OR = 2.36; 95% CI, 1.37-4.07), as well as consistently high levels of family conflict (OR = 1.74; 95% CI, 1.08-2.79) and increases in conflict (OR = 1.87; 95% CI, 1.19-2.94) were independent risk factors for smoking initiation among Mexican heritage youth.
  
  
  CONCLUSIONS
  Our findings suggest that family cohesion protects against adolescent smoking, whereas family conflict increases the risk for smoking. Therefore, intervention programs for adolescents and parents could focus on enhancing family bonding and closeness, which is protective against smoking initiation.
authors.affiliation: Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas; School of Global Studies, Thammasat University, Rangsit, Pathum Thani, Thailand.
authors.forename: Vandita
authors.initials: V
authors.lastname: Rajesh
authors.affiliation: Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Diamond
authors.affiliation: Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Spitz
authors.affiliation: Michael and Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, Austin, Texas. Electronic address: anna.v.wilkinson@uth.tmc.edu.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Wilkinson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D054541:Family Conflict / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017058:Mexican Americans / Q000208:ethnology / Q000523:psychology*; D009769:Object Attachment; D010287:Parent-Child Relations / Q000208:ethnology*; D012907:Smoking / Q000208:ethnology / Q000523:psychology*
keywords: Adolescents; Family cohesion and conflict; Mexican heritage; Smoking