title: Tobacco use among children in Romanian foster care homes.
abstract: Children living in facilities under the supervision of child protection authorities are vulnerable to early smoking experimentation. This is the first study to report the prevalence and correlates of smoking behaviour among foster care home residents in Romania.
  
  
  
  We conducted an in-person, cross-sectional survey of 914 resident children in 148 foster care homes of four Transylvanian counties. We included children <18 and those with complete tobacco use information in the analytical sample (n = 791). Sociodemographic, peer and foster family characteristics were evaluated for their influence on tobacco experimentation and past 30-day use.
  
  
  
  Respondents included 50.7% girls of average age 13.6 years (range 8-17). Almost half reported ever experimenting with tobacco (44.6%) and approximately one in four reported past 30-day use (25.9%). Factors significantly associated with an increased odds of smoking experimentation and past 30-day use in the multivariable model included being 13-17 years old (vs. <12 years), having friends who are current smokers, and having a sibling who smokes. Living in a home with a foster mother or foster father who smokes was associated with increased odds of experimentation and past-30 day use, respectively. The longer time living in foster care was associated with decreased odds of experimentation and past 30-day use controlling for all covariates.
  
  
  
  Anti-tobacco programmes that incorporate the role family and peers to reduce smoking are needed to address the high rates of use among Romanian foster care children.
authors.affiliation: Department of Hygiene, University of Medicine and Pharmacy Targu Mures, Targu Mures, Romania lorandferencz@yahoo.com.
authors.forename: Ferencz Iozsef
authors.initials: FI
authors.lastname: Lorand
authors.affiliation: Department of Hygiene, University of Medicine and Pharmacy Targu Mures, Targu Mures, Romania.
authors.forename: Abram
authors.initials: A
authors.lastname: Zoltan
authors.affiliation: General Directorate of Social Assistance and Child Protection of Mures County, Targu Mures, Romania.
authors.forename: Schmidt
authors.initials: S
authors.lastname: Lorand
authors.affiliation: Institute of Public Health, Semmelweis University, Budapest, Hungary.
authors.forename: Balazs
authors.initials: B
authors.lastname: Peter
authors.affiliation: Comprehensive Cancer Center, Wake Forest University Medical School, Winston-Salem, NC, USA.
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Foley
mesh_terms: D000293:Adolescent; D002648:Child; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D000073865:Cigarette Smoking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012383:Romania / Q000453:epidemiology