title: Transmission of Smoking across Three Generations in Finland.
abstract: The influence of parents' smoking on children's smoking is well known, but few studies have examined the association between grandparents' and grandchildren's smoking. We studied the association between paternal and maternal grandparents' smoking and their grandchildren's tobacco use and assessed whether parents' smoking is a mediator in this process. Data were obtained from a national survey of 12-18-year-old Finns in 2013 (N = 3535, response rate 38%). Logistic regression and mediation analyses were used. Both boys and girls had higher odds for smoking experimentation, daily smoking and other tobacco or tobacco-like product use if their mother, father or any of the four grandparents were current or former smokers. When parents' and grandparents' smoking status were included in the same model, grandparents' smoking generally lost statistical significance. In the mediation analysis, 73% of the total effect of grandparents' smoking on grandchildren's daily smoking was mediated through parents' smoking, 64% on smoking experimentation and 63% on other tobacco or tobacco-like product use. The indirect effect of a mother's smoking was higher than that of a father's. To conclude, paternal and maternal grandparents' smoking increases grandchildren's tobacco use. The influence is mainly, but not completely, mediated through parents' smoking.
authors.affiliation: School of Health Sciences, University of Tampere, 33014 Tampere, Finland. salma.el.amin@staff.uta.fi.
authors.forename: Salma E T
authors.initials: SE
authors.lastname: El-Amin
authors.affiliation: School of Health Sciences, University of Tampere, 33014 Tampere, Finland. jaana.m.kinnunen@staff.uta.fi.
authors.forename: Jaana M
authors.initials: JM
authors.lastname: Kinnunen
authors.affiliation: Tobacco, Gambling and Addiction Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland. hanna.ollila@thl.fi.
authors.forename: Hanna
authors.initials: H
authors.lastname: Ollila
authors.affiliation: School of Health Sciences, University of Tampere, 33014 Tampere, Finland. mika.helminen@uta.fi.|Science Centre, Pirkanmaa Hospital District, 33521 Tampere, Finland. mika.helminen@uta.fi.
authors.forename: Mika
authors.initials: M
authors.lastname: Helminen
authors.affiliation: National School of Public Health, Lisbon NOVA University, P-1600-560 Lisbon, Portugal. joana.alves@ensp.unl.pt.
authors.forename: Joana
authors.initials: J
authors.lastname: Alves
authors.affiliation: School of Health Sciences, University of Tampere, 33014 Tampere, Finland. pirjo.lindfors@uta.fi.|PERLA-Tampere Centre for Childhood, Youth and Family Research, University of Tampere, 33104 Tampere, Finland. pirjo.lindfors@uta.fi.
authors.forename: Pirjo
authors.initials: P
authors.lastname: Lindfors
authors.affiliation: School of Health Sciences, University of Tampere, 33014 Tampere, Finland. arja.rimpela@uta.fi.|PERLA-Tampere Centre for Childhood, Youth and Family Research, University of Tampere, 33104 Tampere, Finland. arja.rimpela@uta.fi.|Department of Adolescent Psychiatry, Pitkäniemi Hospital, Tampere University Hospital, 33380 Nokia, Finland. arja.rimpela@uta.fi.
authors.forename: Arja H
authors.initials: AH
authors.lastname: Rimpelä
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D005219:Father-Child Relations; D005220:Fathers / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D000066502:Grandparents / Q000523:psychology*; D006801:Humans; D016901:Intergenerational Relations; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D016017:Odds Ratio; D012907:Smoking / Q000523:psychology*
keywords: adolescents; grandparents; intergenerational transmission; parents; smoking; tobacco use