Abstract
We use prospective data from the ongoing British Cohort Study (BCS) and Millennium Cohort Study (MCS) to: 1) document changes in the prevalence of childhood smoking onset; 2) assess whether broad historic shifts in key risk factors, such as maternal education, parental smoking, and peer childhood smoking, explain observed cohort changes in childhood smoking; and 3) evaluate whether inequalities in onset have narrowed or widened during this period. The children in these two studies were born 31 years apart (i.e., BCS in 1970; MCS in 2001), and were followed from infancy through early adolescence (n = 23,506 children). Our outcome variable is child self-reports of smoking (ages 10, 11). Early life risk factors were assessed via parent reports in infancy and age 5. Findings reveal that the odds of childhood smoking were over 12 times greater among children born in 1970 versus 2001. The decline in childhood smoking by cohort was partly explained by increases in maternal education, decreases in mothers' and fathers' smoking, and declines in the number of children whose friends smoked. Results also show that childhood smoking is now more linked to early life disadvantages, as MCS children were especially likely to smoke if their mother had low education or used cigarettes, or if the child had a friend who smoked. Although the prevalence of child and adult smoking has dropped dramatically in the past three decades, policy efforts should focus on the increased social inequality resulting from the concentration of early life cigarette use among disadvantaged children.
Highlights
Of smokers, approximately 40% start by early to middle adolescence and early initiation is associated with heavier, chronic use and dependence in later adolescence and adulthood, as well as increased morbidity and mortality (Dunstan, 2012; GBD Tobacco Collaborators, 2015; U.S Department of Health and Human Services [DHHS], 2012)
We rely on two nationally representative birth cohorts: The British Cohort Study (BCS) focuses on all those living in Britain who were born in one week in April 1970
57% of BCS mothers reported no qualifications compared to just over 8% of Millennium Cohort Study (MCS) mothers, and only 7.4% of BCS mothers had achieved at least a post-secondary diploma or qualification (i.e., NVQ 4+), in comparison to over 41% of MCS mothers
Summary
Cohorts (Mostafa, 2014; Mostafa & Wiggins, 2014), such as child gender, ethnic majority status, age, and region, were included in all regressions. To reduce potential bias from item-missing data, we used multiple imputation procedures (Johnson & Young, 2011) in STATA 15 to create 20 complete datasets using chained regressions to impute values for missing data on the predictor variables. These imputed datasets were created separately for each cohort and combined. 0.72 [0.60–0.85] 0.73 [0.62–0.87] 0.70 [0.59–0.83] 0.72 [0.61–0.87] 0.72 [0.60–0.87] Parity
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