title: The intergenerational transmission of tobacco habit: Role of parents and the family.
abstract: BACKGROUND
  Tobacco pandemic has become one of the greatest public health challenges of all time. The socio-environmental factors prevailing at home have been identified as one of the most important causes of adopting smoking and other types of smokeless tobacco.
  
  
  OBJECTIVE
  The present study was conducted to find out the prevalence and pattern of tobacco use in the patients registered in the clinic and to study the role of parental and family influence on tobacco use.
  
  
  METHODS
  This cross-sectional study was performed in a Tertiary Care Hospital in Delhi. The study included all 307 patients who were registered in a cardiac clinic between January and December 2014. The history of tobacco use in siblings, offspring, and parents was taken from these patients. Pedigree profiles provided detailed information about tobacco use in the family. The association between the use of tobacco among parents and tobacco habits was assessed by odds ratio and Chi-square test.
  
  
  RESULTS
  Among the patients, 48% were tobacco users and family history of tobacco use was present in 81% of users. Odds ratio of tobacco use in parents, offspring, siblings, and three generations was 3.477, 1.987, 2.626, and 7.626 than that of nontobacco users.
  
  
  CONCLUSIONS
  Previous anti-smoking campaigns have concentrated much of their effort on discouraging individuals from smoking with the aim of creating a nonsmoking generation. This approach does not take sufficient account of the fact, reconfirmed by our findings that children are influenced by the behavior and attitudes of adults, especially their parents.
authors.affiliation: Senior Consultant Cardiologist, National Heart Institute, East of Kailash, New Delhi, India.
authors.forename: Shridhar
authors.initials: S
authors.lastname: Dwivedi
authors.affiliation: Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India.
authors.forename: Rambha
authors.initials: R
authors.lastname: Pathak
authors.affiliation: Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Agarwalla
authors.affiliation: PvPI-IPC Ghaziabad, Ministry of Health and Family Welfare, Government of India and Posted at ADR Monitoring Centre, Department of Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India.
authors.forename: Wazid
authors.initials: W
authors.lastname: Ali
keywords: Intergenerational transmission; role of parents; tobacco use