Sibling Smoking Research Articles

Positive Association Between Family and Teachers' Tobacco Use on the Smoking Behaviors of Iraqi Adolescents Attending Schools - A Cross Sectional Study Using the Global Youth Tobacco Survey.

Objective: Adolescent tobacco and E-cigarette use have been rising globally in the past decade. Iraq's post-war conflict and economic crises posed psychosocial and mental health trauma, contributing to increased vulnerability to drug and substance use among adolescents. This study looks to assess the potential relationship between current tobacco and E-cigarette smoking and exposure to smoking at home and school among Iraqi adolescents attending schools. Methods: Data analysis for the 2019 Iraq Global Youth Tobacco Survey, a cross-sectional study completed by 2560 Iraqi adolescents aged 11 to 17 years old was conducted. The survey tool which includes demographic, tobacco use, knowledge and attitudes towards tobacco use questions is anonymous and self-administered using paper-based bubble sheets that are scannable. Current tobacco and E-cigarette use (defined as past 30-days) were the main outcomes. Univariate and multivariate logistic regression models were used to assess the relationship between the main outcomes and the following variables: participants' demographics, exposure to smoking, attitude and knowledge scores. Results: Current tobacco and E-cigarette smoking prevalence among Iraqi adolescents attending school were 14.9% (95% CI: 13.5%-16.4%) and 9.7% (95% CI: 8.6%-11.0%), respectively. Exposure to smoking at home was high among fathers (39.1%), mothers (13.9%), siblings smoke (23.9%), other individuals smoke (56.1%). The percentages of students who witnessed people smoking within school premises was 45.7% and observed teachers smoking in schools was 57.6%. The current use of tobacco smoking among Iraqi adolescents was significantly and positively associated with exposure to smoking by the father (AOR = 1.39; 95% CI: 1.05-1.85), mother (AOR = 1.84; 95% CI: 1.30-2.60), sibling (AOR = 3.50; 95% CI: 2.62-4.67), teacher (AOR = 1.48; 95% CI: 1.10-1.98), and people in school (AOR = 1.99; 95% CI: 1.57-2.53). Similarly, the current use of E-cigarettes was significantly associated with father smoking (AOR = 2.02; 95% CI: 1.29-3.16), sibling smoking (AOR = 3.09; 95% CI: 2.04-4.67), and people smoking in school (AOR2.02; 95% CI: 1.39-2.95). Conclusion: Stricter policies need to be enforced to ensure safer school environments that do not expose adolescents to smoking habits of teachers or other students.

Dutch youth's smoking behaviour during a partial Covid-19 lockdown.

Previous research found that adult smokers increased their smoking in response to the Covid-19 lockdown in spring 2020. This study explored changes in youth’s smoking during, compared to before, the partial lockdown in the Netherlands in a cross-sectional sample of 287 adolescents. Smoking prevalence increased from 4.5% to 5.2%. Cigarette consumption remained the same on school days and increased with +1.9 cigarettes per weekend day. The largest increase in cigarette consumption on weekend days was observed for adolescents who 1) did not consider smoking a risk factor for contracting Covid-19 (+4.5), 2) had smoking siblings (+4.1), and 3) had smoking friends (+2.4). Youth without smoking friends (-0.8) and who considered smoking a risk factor for Covid-19 (-0.2) decreased their cigarette consumption. Significance for public health This study reports on a unique period in history of which we have little understanding. Especially in light of the tobacco end game and tobacco control policies, it is important to understand the effects of a lockdown on smoking behaviour of youth.

Dual use of cigarettes and smokeless tobacco among active duty service members in the US military

ABSTRACT The high prevalence of dual use of cigarettes and smokeless tobacco is a unique tobacco use behavior in the US military population. However, dual tobacco use has rarely been addressed in active duty populations. We aimed to identify factors contributing to dual tobacco use among active duty service members from Army and Air Force. We also compared age at initiation, duration of use, and amount of use between dual users and exclusive users. The study included 168 exclusive cigarette smokers, 171 exclusive smokeless tobacco users, and 110 dual users. In stepwise logistic regression, smokeless tobacco use among family members (OR = 4.78, 95% CI = 2.05–11.13 for father use vs. no use, OR = 3.39, 95% CI = 1.56–7.37 for other relatives use vs. no use), and deployment history (serving combat unit vs. combat support unit: OR = 4.12, 95% CI = 1.59–10.66; never deployed vs. combat support unit: OR = 3.32, 95% CI = 1.45–7.61) were factors identified to be associated with dual use relative to exclusive cigarette smoking. Cigarette smoking among family members (OR = 1.96, 95% CI = 1.07–3.60 for sibling smoking), high perception of harm using smokeless tobacco (OR = 2.34, 95% CI = 1.29–4.26), secondhand smoke exposure (OR = 4.83, 95% CI = 2.73–8.55), and lower education (associated degree or some college: OR = 2.76, 95% CI = 1.01–7.51; high school of lower: OR = 4.10, 95% CI = 1.45–11.61) were factors associated with dual use relative to exclusive smokeless tobacco use. Compared to exclusive cigarette smokers, dual users started smoking at younger age, smoked cigarettes for longer period, and smoked more cigarettes per day. Our study addressed dual tobacco use behavior in military population and has implications to tobacco control programs in the military.

Exposure to parental and sibling smoking and future intentions to smoke among 13-15 years old school age children in Saudi Arabia.

Introductionprevalence of smoking in school children is alarming in Saudi Arabia and little is well-known about the aspects stimulating such behaviours in secondary school children. The aim of this study was to assess the association between influence of parent/sibling/peer smoking and future intentions to initiate smoke among 13-15 years old school children in Al Ras town, Saudi Arabia.Methodsa cross sectional survey was conducted in Al Ras city during first quarter of 2019. Data was collected from 492 secondary school children who were selected through multistage stratified cluster sampling. Pretested, self-administered Arabic questionnaire was used to collect data about socio-demographic and prevalence of current smoking behaviours and associated factors. Descriptive statistics was done initially, following by binomial regression to assess the predictors of current smoking and future smoking intentions.Resultsthe overall prevalence of smoking in respondents was 22.7% and statistically significant difference in smoking prevalence's between boys and girls was observed (40% vs 5.6%). Among the predictors of current smoking, smoking habits in siblings and getting pocket money over 200 Saudi riyals are found to be significant. Siblings smoking (odds ratio: 6.4) and poor academic performance (odds ratio: 3.2) were the two most important factors influencing children's intentions of smoking.Conclusionsmoking prevalence in secondary school children of Al Ras was similar to national data. Since, influence of siblings, getting more pocket money and poor academic performance were found to important predictors of children smoking behaviours and attitudes, health education programs should address these factors to be effective.

Tabaquismo en los estudiantes de alto nivel académico en la Comunidad de Madrid y comparación con estudio previo similar realizado en 2014

Smoking is a public health problem that affects young people, and influenced by the environment and cultural level. ObjectivesTo determine smoking prevalence among high-level baccalaureate students in the Autonomous Community of Madrid during the 2018-2019 academic year. To assess the influence of the socio-cultural environment on the onset of youth smoking. To compare the results with previous studies conducted on students of baccalaureate of excellence (BE) and the general population. Population and methodsCross-sectional study on BE students in the Autonomous Community of Madrid. Using an anonymous questionnaire, they were asked about tobacco, alcohol and drug consumption, as well as the influence of the environment, friends, and family in the beginning. To compare with previous studies. ResultsA total of 740 valid questionnaires were collected, of which 430 (58.1%) were female, an overall mean age of 16.57±0.61 years, and 53 (7.18%) were smokers. The majority 39 (78%) of smokers acknowledged their friends’ influence at its onset. Alcohol was consumed by 349 (47.48%) and other drugs by 109 (15.27%). Being a smoker was related to alcohol, other drugs, a smoking mother, smoking siblings and smoking friends. ConclusionsSmoking prevalence among students of BE in Autonomous Community of Madrid continues to be lower than the prevalence of adolescents of their age and there are no variations from previous reports. Starting smoking is related to smoking by friends, siblings, and the mother and with the consumption of alcohol and other substances.Education is very important in the beginning and prevention of smoking, and it is necessary to implement prevention programs at early ages in order to promote their effectiveness, and aimed at young people, parents and teachers.

Intergenerational transmission of gender social norms and teenage smoking

This paper provides evidence of different teenage-smoking dynamics between genders with social progression. In particular, we find that descending from more gender-equal societies makes girls relatively more prone to smoke than those from less gender-equal societies relative to their male counterparts. Using data from over 6,000 second-generation immigrant teenagers sharing culture and institutions from one host country (Spain) but coming from 45 different countries of ancestry, we find that the higher the degree of gender equality in the country of ancestry, the higher the likelihood that girls smoke relative to boys. Our result holds even after we control for parental, sibling, and peer smoking, as well as for country-of-ancestry indicators of economic development and the smoking gender gap, among others.

Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002–2015

ObjectivesAdolescent smoking has declined in New Zealand and in many other countries since the late 1990s, yet the reasons for the decline are not well understood. We investigated the extent...

Perceived family relationship quality and use of poly-tobacco products during early and late adolescence

BackgroundThe role of family relationship in adolescent use of emerging tobacco products, which have become increasingly popular, is unknown. We examined the associations of perceived family relationship quality with current use of poly-tobacco products including cigarettes, electronic cigarettes (e-cigarettes), waterpipe and smokeless tobacco in adolescents. MethodsData from a representative sample of 42,250 US grade 7–12 equivalent students (mean ± SD age 14.6 ± 1.9 years; 51.3% boys) from 75 randomly selected secondary schools in Hong Kong (2012−13) were analysed. Logistic regressions yielded adjusted odds ratios (AORs) for current (past 30-day) use of cigarettes, e-cigarettes, waterpipe, smokeless tobacco and poly-tobacco (≥2 products) in relation to perceived family relationship quality, adjusted for age, sex, perceived family affluence, parental education, family structure, parental and sibling smoking and secondhand smoke exposure at home. Subgroup analyses were conducted to compare the associations in early (aged ≤14 years) versus late (>14) adolescents. ResultsThe odds of current use increased with worse perceived family relationship quality with AORs (95% confidence interval) of up to 2.92 (2.32–3.68) for cigarettes, 7.28 (4.71–11.2) for e-cigarettes, 5.04 (3.44–7.40) for waterpipe, 8.09 (4.87–13.4) for smokeless tobacco and 5.25 (3.45–8.01) for poly-tobacco products use (all P for trend <.001). The associations for all tobacco use outcomes were stronger in early than late adolescents (all P for interaction <.001). ConclusionsDose-response relationships were found between negatively perceived family relationship quality and current poly- and individual tobacco product use by Hong Kong Chinese secondary students. The associations were stronger for alternative tobacco products and in early adolescents.

Addressing Ethnic Disparities in Adolescent Smoking: Is Reducing Exposure to Smoking in the Home a Key?

Smoking among New Zealand (NZ) adolescents has declined since 2000, but ethnic disparities remain pronounced. To inform prevention efforts, we investigated exposure to and relative importance of known predictors of adolescent smoking and how these have changed over time, for Māori (NZ's indigenous population) and adolescents overall. We used repeat cross-sectional data, 2003-2015, from a national survey of 14- to 15-year olds (N = 20 443-31 696 per year). For the overall sample and for Māori and non-Māori, we calculated adjusted odds ratios (aORs) to assess the association between regular smoking and risk factors each year: one or more parents smoke, best friend smokes, older sibling(s) smoke, and past week exposure to smoking in the home. We calculated population attributable risk (PAR) for risk factors in 2003 and 2015. Between 2003 and 2015, aORs for exposure to smoking in the home increased from 1.7 (95% CI 1.6% to 1.8%) to 2.6 (2.1% to 3.1%) overall and from 1.8 (1.6% to 2.1%) to 3.4 (2.5% to 4.5%) for Māori; aORs for "best friend smokes" also increased, while aORs for sibling smoking and parental smoking did not change meaningfully. PAR for exposure to smoking in the home increased from 17% to 31% overall and from 28% to 57% for Māori, while PARs for other risk factors decreased. Exposure to smoking in the home has become more strongly associated with adolescent smoking over time and is an increasingly important risk factor at the population level (independent of parental smoking), particularly for Māori. Our findings have implications for reducing smoking uptake and ethnic disparities in NZ, and potentially elsewhere, given the similarity in risk factors and trends for adolescent smoking internationally. Our findings suggest that reducing second-hand smoke exposure in homes will likely reduce uptake of smoking. Because Māori children are both more exposed and appear to be more strongly influenced by exposure to smoking in the home, interventions to reduce indoor smoking could have differentially positive effects for Māori. Greater research and policy attention to reducing smoking in homes is warranted.

Tobacco smoking in Egypt: a scoping literature review of its epidemiology and control measures

According to World Health Organization (WHO) reports, the prevalence of smoking is increasing in many developing countries, including Egypt. The aim of this study is to summarize the published data in the literature about tobacco smoking in Egypt. A computerized literature search of PubMed and relevant Egyptian journals was conducted using the relevant keywords. The findings of retrieved studies were extracted and discussed in a narrative approach. Our search retrieved 44 relevant studies. The most updated prevalence of tobacco smoking in Egypt is 22% in 2010 and is increasing. Highly significant odds ratios were reported for sibling, parent, and peer smoking as risk factors for smoking. Cardiovascular disorders, malignant tumors, and erectile dysfunction are common complications of smoking in the Egyptian population. Efforts to control tobacco smoking are available, but inadequate. Tobacco smoking is a prevalent health problem in Egypt, associated with cardiovascular disorders and malignant tumors. Health education programmes should be delivered through mass media and school-based programmes to reach a large section of the Egyptian population.

Brand Awareness and Access to Cigarettes Among Children 8-12 Years Old in the Czech Republic

The aim of the study is to assess smoking behaviour, knowledge of cigarette brands and access to cigarettes among children 8-12 years old in the Czech Republic. Between 2009 and 2012, a cross sectional survey was conducted among 4,439 children aged 8-12 years attending 51 primary schools in Prague and Central Bohemia, Czech Republic. Data including age, gender, ever smoking, parental and sibling smoking, knowledge of cigarette brands, sources of cigarettes, and smoking frequency were collected. Fifty nine percent of all children could name one or more cigarette brands, 62.8% of boys and 55.3% of girls (p<0.01). The most well-known brands were Marlboro and the local brand Petra. Marlboro was better known among boys, while Petra was more known among girls. Children whose parents smoke showed higher brand awareness than children with non-smoking parents, 72.5% and 45.6%, respectively (p<0.001), and 76.4% of children reported one or more possible sources where to obtain cigarettes. Nearly one quarter (23.3%) of children had ever tried cigarettes, water pipe, cigars, or marijuana. Nearly half of all children (43.1%) reported that they had obtained their first cigarette from a relative or at home, and the second most frequent source were their peers (22.8%). Only 3.9% of children reported that they had purchased their first cigarettes. Relatives were the main source of cigarettes among children that reported smoking more than once. The high level of cigarette brand awareness and ever smoking provide evidence that tobacco control policies in the Czech Republic do not adequately protect children. Tougher legislation and effective strategies in accordance with the WHO Framework Convention on Tobacco Control are therefore required to better protect children from harmful effects of smoking and the influence of tobacco industry in the Czech Republic.

Gender differences in risk factors for cigarette smoking initiation in childhood

IntroductionWe investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender. MethodsIn spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005–2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys. Results101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade. ConclusionsRisk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use.

Psychological and Familial Factors of Depression in Relation to Adolescent Smoking Behavior.

Background:Several common factors have been identified for smoking and depression. The The present study explores the relation of psychological and familial factors with depression, by student smoking behavior.Materials and Methods:A total of 5500 middle- and high-school students were selected in Isfahan province in 2010. A self-administered questionnaire collected data on background characteristics, smoking status, depression, and risk factors. Univariate analysis multiple logistic regressions were conducted to compare between depressed and nondepressed people by adolescent smoking status. Odds ratios and the corresponding 95% confidence intervals (CIs) were reported.Results:Fathers lower education attainment was accompanied adolescents higher depression prevalence. Parental smoking and sibling smoking increased the depression likelihood by 1.41 (95% CI: 1.18, 1.68) and 1.43 folds (95% CI: 1.04–1.94) for never-smokers. Positive attitude toward smoking increased the probability of depression by 1.18 among never-smokers. Never-smokers lacking refusal skill had 1.23 (1.03–1.47) higher chance of depression. A higher level of self-efficacy related to lower chance of depression. Taking risky behavior, increased the depression likelihood by 1.56 (95% CI: 1.29–1.89) in never-smokers, by 1.85 (95% CI: 1.37–2.44) in experimental smokers, and by 1.14 times (95% CI: 1.01–1.72) in current smokers. Family conflict increased depression chance by 2.25 times (95% CI: 1.89–2.66) in never-smokers, by 1.95 (95% CI: 1.46–2.61) in experimental smokers, and by 2.06 times (95% CI: 1.38–3.08) in current smokers.Conclusions:Targeting self-efficacy level, risky behavior, and family conflict can drop the comorbidity of smoking and depression simultaneously. This may help public health practitioners and policymakers to develop common strategies in reducing adolescents smoking and depression comorbidity.

Human enterovirus and rhinovirus infections are associated with otitis media in a prospective birth cohort study

BackgroundHuman enteroviruses (HEVs) and rhinoviruses (HRVs) have been linked to acute otitis media (AOM). ObjectivesThe present study evaluates the aforementioned association in a birth cohort setting. Study designThe cohort included 286 healthy infants (191 boys) followed from birth up to the age of 2 years in the Type 1 Diabetes Prediction and Prevention study in Finland. Stool samples were collected monthly and analyzed for the presence of HRV and HEV RNA using RT-PCR. Clinical symptoms were recorded by a questionnaire every 3–6 months. ResultsAltogether 610 AOM episodes were reported during the follow-up. 9.8% of the stool samples were positive for HRV and 6.8% for HEV. HRV positivity peaked at the age of 3–6 months declining gradually after this age, whereas HEV positivity peaked later, at the age of 12–24 months. The risk of AOM was increased in children who were HEV positive at least once at the age of 6–12 months (OR 2.2 [95%CI 1.1–4.2], P=0.023) or who were HRV positive at least once at the age of 18–24 months (OR 2.3 [95%CI 1.0–5.2], P=0.042). Having an older sibling, short breast-feeding and maternal smoking during pregnancy were also significantly associated with AOM. ConclusionsHRV and HEV infections are frequent during the first months of life. The observed trend for increased risk of AOM in HRV and HEV positive children is in line with the results from hospital series suggesting that these viruses may play an independent role in the pathogenesis of AOM.

Factors Influencing Adolescent Lifetime Smoking and Current Smoking in South Korea: Using data from the 10th (2014) Korea Youth Risk Behavior Web-Based Survey

The purpose of this study was to investigate factors influencing lifetime smoking and current smoking among adolescents in South Korea. Hierarchical logistic regression was conducted based on complex sample analysis using statistics from the 10th (2014) Korea Youth Risk Behavior Web-Based Survey. The study sample comprised 72,060 adolescents aged 12 to 18. The significant factors influencing adolescent lifetime smoking were female gender, older age, higher stress, higher weekly allowance, lower economic status, living apart from parents, parental smoking, sibling smoking, peer smoking, observation of school personnel smoking, and coed school compared to boys' school. The significant factors influencing adolescent current smoking were female gender, older age, higher stress, higher weekly allowance, both higher and lower economic status compared to middle economic status, living apart from parents, parental smoking, sibling smoking, peer smoking, observation of school personnel smoking, and coed school compared to boys' school. Factors identified in this study need to be considered in programs directed at prevention of adolescent smoking and smoking cessation programs, as well as policies.

Social Norms and Teenage Smoking: The Dark Side of Gender Equality

This paper is the first to provide evidence that cultural attitudes towards gender equality affect behaviors with potentially devastating health consequences, and that they do so differently for male and female teenagers. In particular, we show that descending from more gender-equal societies makes girls relatively more prone to smoke than boys. Using data from over 6,000 second-generation immigrant teenagers coming from 45 different countries of ancestry and living in Spain, we find that the higher the degree of gender equality in the country of ancestry, the higher the likelihood that immigrant girls smoke relative to boys, even after we control for parental, sibling, and peer smoking. Importantly, we uncover similar patterns when analyzing other risky behaviors such as drinking or smoking marijuana. This reinforces the idea that more gender-equal social norms may come at an extra cost to women's health, as they increasingly engage in risky behaviors (beyond smoking) traditionally more prevalent among men.

Influence of family and friend smoking on intentions to smoke and smoking-related attitudes and refusal self-efficacy among 9-10 year old children from deprived neighbourhoods: a cross-sectional study.

BackgroundSmoking often starts in early adolescence and addiction can occur rapidly. For effective smoking prevention there is a need to identify at risk groups of preadolescent children and whether gender-specific intervention components are necessary. This study aimed to examine associations between mother, father, sibling and friend smoking and cognitive vulnerability to smoking among preadolescent children living in deprived neighbourhoods.MethodsCross-sectional data was collected from 9–10 year old children (n =1143; 50.7% girls; 85.6% White British) from 43 primary schools in Merseyside, England. Children completed a questionnaire that assessed their smoking-related behaviour, intentions, attitudes, and refusal self-efficacy, as well as parent, sibling and friend smoking. Data for boys and girls were analysed separately using multilevel linear and logistic regression models, adjusting for individual cognitions and school and deprivation level.ResultsCompared to girls, boys had lower non-smoking intentions (P = 0.02), refusal self-efficacy (P = 0.04) and were less likely to agree that smoking is ‘definitely’ bad for health (P < 0.01). Friend smoking was negatively associated with non-smoking intentions in girls (P < 0.01) and boys (P < 0.01), and with refusal self-efficacy in girls (P < 0.01). Sibling smoking was negatively associated with non-smoking intentions in girls (P < 0.01) but a positive association was found in boys (P = 0.02). Boys who had a smoking friend were less likely to ‘definitely’ believe that the smoke from other people’s cigarettes is harmful (OR 0.57, 95% CI: 0.35 to 0.91, P = 0.02). Further, boys with a smoking friend (OR 0.38, 95% CI: 0.21 to 0.69, P < 0.01) or a smoking sibling (OR 0.45, 95% CI: 0.21 to 0.98) were less likely to ‘definitely’ believe that smoking is bad for health.ConclusionThis study indicates that sibling and friend smoking may represent important influences on 9–10 year old children’s cognitive vulnerability toward smoking. Whilst some differential findings by gender were observed, these may not be sufficient to warrant separate prevention interventions. However, further research is needed.

A path model of smoking behaviour among senior high school students in Taiwan

Objective: The purpose of this study was to explore the ways in which social smoking expectations mediate the relationship between adolescent smoking behaviour and the smoking behaviour of family and peers. Design: Descriptive, cross-sectional survey. Setting: Taiwan, Republic of China. Method: The participants were 921 senior high school students who completed a questionnaire to measure smoking status, family and peer smoking and social smoking expectations. The survey was conducted from November to December in 2009. Structural equation modelling was performed to test a mediation model. Analysis was performed using PRELIS 2 and LISREL 8.7 software. Results: After adjusting for students’ gender, age and school type, it is clear that social expectations mediate the relationship between sibling smoking, peer smoking and adolescent smoking. The path coefficients of sibling and peer smoking on social expectations in the mediator model were moderate, β = .15–.41, p &lt; .05, but the coefficient of social expectations on adolescent smoking was strong, β = .95, p &lt; .001. The total indirect effects between exogenous latent variables and adolescent smoking were .54, indicating a strong association that, in this model, is explained by the mediation of social expectations. Conclusion: Determining the mechanisms that influence adolescent smoking is of scientific interest because knowledge of these mechanisms is a prerequisite for the development of recommendations aimed at prevention. With this knowledge, health professionals can develop smoking-prevention policies and education programmes based on reducing the mediating effect of social smoking expectations on the relationship of family smoking and peer smoking with adolescent smoking.

The Influence of Family Factors on Smoking Behavior in Turkey

Aim: The goal of this study is to specify the risks, family and environmental factors affecting smoking behavior and develop suggestions for Turkish individuals by considering sibling data. Materials and Methods: The data was collected by voluntary senior year students attending Kırıkkale University, Department of Statistics. The sample of 751 families was selected from families with at least two children. Each sibling’s socio-demographic information and behavioral phenotypes were collected using a survey from both siblings. We selected one of siblings randomly as ‘sibling1’ and defined the other sibling as ‘sibling2’. Hypothesis testing and multivariable clustered logistic regression models were used to evaluate the data and find the optimum model by using dependent sibling data. Results: Out of 1502 (751 pairs) siblings 843 (56.1%) were males, 659 (43.9%) were females. According to the survey results, 508 of the males (67.7%) and 242 of the females (32.3%) were smokers for a month or longer and smoked every day. The risk of smoking was 2.26 times higher in males than in females. Having a smoking sibling increased the risk of smoking 1.95 times, alcohol using increased the risk 2.11 times. We found that when the age difference between siblings is 0-7 years, having a same sex sibling who smokes increases one’s risk 4.7 times in females and 5 times in males; when the siblings are of different sexes, according to these age differences Conclusion: The survey showed that the gender and sibling’s and parent’s smoking both play a significant role on smoking behavior. But children seem to learn smoking from their siblings more than from parents. Having same sex sibling who smokes plays significant role in smoking behavior for both males and females.

Smoking behaviours of adolescents, influenced by smoking of teachers, family and friends

Smoking tobacco is a global health problem, and this study highlights adolescent smoking in Taiwan. Smoking was completely banned on campuses under the Tobacco Hazards Prevention Act and School Health Regulations. Few have investigated the association between personnel smoking/school smoking policies and adolescent smoking in Taiwan. The smoking rate has gradually increased for senior high school students in Taiwan from 10.7% in 1994 to 14.7% in 2011. This study examined the influence of family and friends' smoking on the association between the presence of teachers smoking and each stage of adolescents' smoking behaviour. A cross-sectional survey was conducted in nine high schools (n = 921). Logistic regression analysis was used to examine the association between smoking stage, father smoking, mother smoking, sibling smoking, friends smoking and the presence of smoking teachers. After adjusting for gender, school type and grade, fathers', siblings' and friends' smoking were significantly associated with adolescents' ever and current smoking behaviours, but mothers' smoking was only associated with adolescents' current smoking behaviours. Friends' smoking was strongly associated with being a smoker. While there was an interaction between friends' smoking and the presence of smoking teachers on current smoking behaviours indicating the effect of the presence of smoking teachers was increased when friends did not smoke. The results suggest that teachers smoking on school may increase the likelihood of being a current smoker as their friends do not smoke. Family and friends smoking are associated with adolescent smoking. The Taiwanese government has regulated a comprehensive smoking ban in schools to prohibit both student and staff smoking on all school premises. To achieve this, schools should make tobacco control communication efforts. Nurses could address the combined influence of family and friends as well as the effect of school smoking restrictions to help prevent adolescents from smoking.