Parental Smoking Behavior Research Articles

Keeping it in the Family? If Parents Smoke Do Children Follow?

I use retrospective data on smokers from the German Socio-Economic Panel to investigate whether children are more likely to smoke if their parents smoke(d). Despite intense policy interest, researchers have not established whether the well-established (positive) association is causal. I exploit panel data observations on smoking behavior of parents and children to develop instrumental variables that identify the causal relationship between parental smoking and youth initiation. The results suggest that children are not more or less likely to start smoking if their parents smoke. Failing to control for the endogenous choice of parents to smoke leads to incorrect inferences. JEL Classification: I12

Surgery and Smoking at First and Second Hand

Surgery and Smoking at First and Second Hand

Smoking onset and the time-varying effects of self-efficacy, environmental smoking, and smoking-specific parenting by using discrete-time survival analysis.

This study examined the timing of smoking onset during mid- or late adolescence and the time-varying effects of refusal self-efficacy, parental and sibling smoking behavior, smoking behavior of friends and best friend, and parental smoking-specific communication. We used data from five annual waves of the ‘Family and Health’ project. In total, 428 adolescents and their parents participated at baseline. Only never smokers were included at baseline (n = 272). A life table and Kaplan–Meier survival curve showed that 51% of all adolescents who did not smoke at baseline did not start smoking within 4 years. The risk for smoking onset during mid- or late adolescence is rather stable (hazard ratio between 16 and 19). Discrete-time survival analyses revealed that low refusal self-efficacy, high frequency of communication, and sibling smoking were associated with smoking onset one year later. No interaction effects were found. Conclusively, the findings revealed that refusal self-efficacy is an important predictor of smoking onset during mid- or late adolescence and is independent of smoking-specific communication and smoking behavior of parents, siblings, and (best) friend(s). Findings emphasize the importance of family prevention programs focusing on self-efficacy skills.

Parental Tobacco Control in the Child Healthcare Setting

Each year 40% of the worldapos;s children are exposed to tobacco smoke and 166,000 children die from that exposure annually. The 2006 and 2010 U.S. Surgeon General Reports concluded that there is no safe level of tobacco smoke exposure (TSE). The only way to completely protect children from the dangers of household TSE is to help all household members quit. Due to the many health concerns associated with children's TSE, parental tobacco control is a priority within the pediatric setting. Child healthcare clinicians are in a unique position to influence the smoking behaviors of parents, thereby improving the health of their patients. The Clinical and Community Effort Against Secondhand Smoke Exposure (CEASE) is a parental tobacco control intervention that uses an operational form of the U.S. Department of Health and Human Service's (HHS) Treating Tobacco Use and Dependence Guideline in the context of the child's outpatient medical visit. The CEASE method includes three steps (Ask, Assist, Refer) that encompass the goals of the 5A's (Ask, Advise, Assess, Assist, Arrange) in a simplified format, allowing for brief, tailored cessation support for the person who smokes. This paper summarizes the research on the harms of TSE and explores how child healthcare clinicians can most effectively eliminate these health risks to children by implementing CEASE. Finally, we look at legislative initiatives that clinicians can support to help protect children from the harms of TSE.

Contribution of socioeconomic status to smoking behavior of parents of 4th grade elementary school students in Japan

Contribution of socioeconomic status to smoking behavior of parents of 4^th grade elementary school students in Japan

Smoking is rank! But, not as rank as other drugs and bullying say New Zealand parents of pre-adolescent children

Despite the established risks associated with smoking, 21% of New Zealand adults smoke. Prevalence among Māori (indigenous) and Pacific Island New Zealanders is disproportionately high. Prevention of smoking initiation is a key component of tobacco control. Keeping Kids Smokefree--a quasi-experimental trial--aimed to do this by changing parental smoking behaviour and attitudes. However, little is known about parents' attitudes to smoking in comparison with other concerns. Parents of 4,144 children attending five urban schools in a high smoking prevalence population in Auckland, New Zealand, were asked to rank seven concerns on a paper-based questionnaire, including smoking, alcohol and bullying, from most to least serious. Methamphetamine and other illicit 'hard' drugs were ranked as most serious followed by marijuana smoking, alcohol drinking, bullying, cigarette smoking, sex and obesity. Never smokers ranked cigarette smoking as more serious than current or ex-smokers. Parents' under-estimation of the serious nature of tobacco smoking relative to other drugs could partly explain low participation rates in parent-focused smoking initiation prevention programs.

Quantifying the Cost of Passive Smoking on Child Health: Evidence from Children’s Cotinine Samples

Summary We document the main risk factors that determine children’s exposure to passive smoke, and we use econometric techniques to provide a new economic quantification of the effect of this exposure on child health. One of our main contributions is the use of a large nationally representative sample of children drawn from the Health Survey for England, for whom we match parental and household smoking and demographic characteristics. We use an objective measure of children’s exposure, namely the level of cotinine in their saliva. We find that both parental and child carer smoking behaviour are major risk factors in determining children’s exposure to passive smoke. For a child who is exposed to a high number of passive smoking risk factors, the income equivalence of such exposure is £16000 per year. Finally, comprehensively controlling for child passive smoking does not explain the observed gradient between household income and parental-reported child health in England.

Longer Breastfeeding Is Associated with Increased Lower Body Explosive Strength during Adolescence

Our aim in this study was to examine the association between breastfeeding duration and cardiorespiratory fitness, isometric strength, and explosive strength during adolescence. A total of 2567 adolescents (1426 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study aged 12.5–17.5 y were included. Information about duration of any and exclusive breastfeeding was obtained retrospectively by means of a parental questionnaire. The 20-m shuttle run, handgrip strength, and standing long jump tests were used to assess physical fitness. Significant differences among the categories of breastfeeding duration were tested using ANCOVA after adjusting for a set of potential confounders: gestational and current age, birth weight, sexual maturation, fat mass, fat-free mass, maternal education, parental weight status, country, smoking behavior, and days of vigorous physical activity. Longer breastfeeding (either any or exclusive) was associated with a higher performance in the standing long jump test in both boys and girls (P < 0.001), regardless of fat mass, fat-free mass, and the rest of potential confounders. In adolescents who were breastfed for 3–5 mo or ≥6 mo, the risk of having a standing long jump performance below the 5th percentile was reduced by half compared with those who were never breastfed [odds ratio (OR) = 0.54, 95% CI = 0.30–0.96, P < 0.05; and OR = 0.40, 95% CI = 0.22–0.74, P < 0.01, respectively). These findings suggest a role of breastfeeding in determining lower body explosive strength during adolescence.

Keeping Kids Smokefree: Rationale, Design, and Implementation of a Community, School, and Family-Based Intervention to Modify Behaviors Related to Smoking among Māori and Pacific Island Children in New Zealand

Despite a concerted, sustained and comprehensive tobacco control effort, smoking is prevalent among young people in New Zealand, particularly for Māori and Pacific Island teenagers. Many took up smoking in their pre-teen years. New Zealand research has shown that daily smoking by children aged 14-15 years is strongly influenced by parental smoking. The Keeping Kids Smokefree study is investigating whether changing parental smoking behavior and attitudes via a community-partnership approach with parents, schools, and local health providers can reduce smoking initiation by 11-12 year olds. It is a quasi-experimental trial involving four schools in an urban area of high social deprivation with large numbers of Māori and Pacific Islands families. Schools were allocated to intervention or control and the intervention was developed through a process of engagement with the schools, parents of children and local healthcare organizations. This article describes the rationale, context, methodology and methods involved in establishing the study. Building Māori and Pacific Islander research capacity was a secondary objective of the study.

Smoking‐based selection and influence in gender‐segregated friendship networks: a social network analysis of adolescent smoking

The main goal of this study was to examine differences between adolescent male and female friendship networks regarding smoking-based selection and influence processes using newly developed social network analysis methods that allow the current state of continuously changing friendship networks to act as a dynamic constraint for changes in smoking behaviour, while allowing current smoking behaviour to be simultaneously a dynamic constraint for changes in friendship networks. Longitudinal design with four measurements. Nine junior high schools in Finland. A total of 1163 adolescents (mean age = 13.6 years) who participated in the control group of the ESFA (European Smoking prevention Framework Approach) study, including 605 males and 558 females. Smoking behaviour of adolescents, parents, siblings and friendship ties. Smoking-based selection of friends was found in male as well as female networks. However, support for influence among friends was found only in female networks. Furthermore, females and males were both influenced by parental smoking behaviour. In Finnish adolescents, both male and female smokers tend to select other smokers as friends but it appears that only females are influenced to smoke by their peer group. This suggests that prevention campaigns targeting resisting peer pressure may be more effective in adolescent girls than boys.

Dynamics of adolescent friendship networks and smoking behavior: Social network analyses in six European countries

The co-evolution of adolescents' friendship networks and their smoking behavior is examined in a large sample across six European countries. Selection and influence processes are disentangled using new methods of social network analysis that enable alternative selection mechanisms to be controlled for. The sample consisted of 7704 adolescents participating in the control group of the ESFA (European Smoking prevention Framework Approach) study. The design was longitudinal with four observations. The main measurements were friendship ties, adolescents smoking behavior, parental smoking behavior, and sibling smoking behavior. Results indicated that in each country adolescents preferred selecting friends based on similar smoking behavior. Support for the influence of friends was found in only two countries. A similarity in smoking behavior between friends was explained more strongly by smoking-based selection processes than by the influence of friends in each of the six countries. Prevention programs need to address aspects that drive peer selection, and reinforce non-smoking attitudes in adolescents.

Secondhand Smoke May Be Associated with an Increased Risk of Primary Tooth Caries

Article Title and Bibliographic Information Parental smoking behavior and caries experience in preschool children. Leroy R, Hoppenbrouwers K, Jara A, Declerck D. Community Dent Oral Epidemiol 2008. 36(3):249-57. Reviewers Jonathan D. Shenkin, DDS, MPH John Warren, DDS, MS Purpose/Question To determine if secondhand smoke was associated with dental caries in preschool-age children while controlling for other known confounders. Source of Funding Industry supported with funding from GABA Benelux and GABA International, Therwil, Switzerland. Type of Study/Design Cross-sectional study Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable

Smoking initiation in Germany: the role of intergenerational transmission

This paper analyzes the decision to start smoking using data from the German Socio-Economic Panel (GSOEP). Our focus is on the role that parental smoking behavior plays for children's smoking initiation. The data used are a combination of retrospective information on the age individuals started smoking and, by tracing back these individuals within the panel structure up to that point, information on characteristics at the age of smoking initiation. In contrast to the previous literature it is possible to control for the environment at the time of smoking onset that might have influenced the decision to start. Our preferred specification of a discrete time hazard model indicates that parental smoking significantly increases the offspring's hazard to start smoking. While this effect is most prominent for currently smoking parents, it is also found for parents who have given up smoking already. However, an ambiguous effect of the timing of parental smoking cessation is found, arguing against role-model effects being a key determinant for smoking initiation.

The impact of a minimal smoking cessation intervention for pregnant women and their partners on perinatal smoking behaviour in primary health care: a real-life controlled study.

BackgroundThere is a demand for strategies to promote smoking cessation in high-risk populations like smoking pregnant women and their partners. The objectives of this study were to investigate parental smoking behaviour during pregnancy after introduction of a prenatal, structured, multi-disciplinary smoking cessation programme in primary care, and to compare smoking behaviour among pregnant women in the city of Trondheim with Bergen and Norway.MethodsSequential birth cohorts were established to evaluate the intervention programme from September 2000 to December 2004 in primary care as a part of the Prevention of Allergy among Children in Trondheim study (PACT). The primary outcome variables were self reported smoking behaviour at inclusion and six weeks postnatal. Data from the Medical Birth Registry of Norway (MBR) were used to describe smoking cessation during pregnancy in Trondheim, Bergen and Norway 1999–2004.ResultsMaternal smoking prevalence at inclusion during pregnancy were 5% (CI 95% 4–6) in the intervention cohort compared to 7% (CI 95% 6–9), p = 0.03, in the control cohort. Of the pre-pregnancy maternal smokers 25% (CI 95% 20–31) and 32% (CI 95% 26–38), p = 0.17, were still smoking at inclusion in the intervention and control cohorts, respectively. Six weeks postnatal 72% (CI 95% 59–83) and 68% (CI 95% 57–77), p = 0.34 of the maternal smokers at inclusion still smoked. No significant difference in paternal smoking between the cohorts was found after the intervention period. Data from the MBR showed a significantly higher proportion of women who stopped smoking during pregnancy in Trondheim than in Bergen in 2003 and 2004, p = 0.03 and < 0.001, respectively.ConclusionNo impact on parental smoking behaviour between the cohorts was observed after the smoking intervention programme. Of the women who stopped smoking during pregnancy most of them stopped smoking before the intervention. However, we observed a significantly higher quitting rate in Trondheim than in Bergen in 2003 and 2004 which may have been facilitated by the supplemental attention on smoking behaviour the PACT study initiated.

Parental smoking and adolescent problem behavior: an adoption study of general and specific effects.

It is essential to understand the effect of parental smoking on offspring tobacco use. In biologically related families, parents who smoke may transmit a nonspecific genetic risk for offspring disinhibited behavior, including tobacco use. Studying adoptive families allows one to control for genetic confounding when examining the environmental effect of exposure to parental smoking. The purpose of this study was to examine the genetic and environmental contributions to the risk represented by exposure to parental smoking and to assess the specificity of that risk. Adolescents adopted in infancy were systematically ascertained from records of three private Minnesota adoption agencies; nonadopted adolescents were ascertained from Minnesota birth records. Adolescents and their rearing parents participated in all assessments in person. The main outcome measures were self-reports of behavioral deviance, substance use, and personality, as well as DSM-IV clinical assessments of childhood disruptive disorders. The data from adoptive families suggest that exposure to parental smoking represents an environmental risk for substance use in adolescent offspring. In biologically related families, the effect of exposure to parental smoking is larger and more diverse, including substance use, disruptive behavior disorders, delinquency, deviant peer affiliations, aggressive attitudes, and preference for risk taking. This study provides evidence for an environmentally mediated pathway by which parental smoking increases risk specifically for substance use in adolescent offspring. The data are also consistent with a genetically mediated pathway by which nonadoptive parents who smoke may also transmit a nonspecific genetic risk to their offspring for disinhibited behavior.

Adolescent Smoking Trajectories: Results from a Population-Based Cohort Study

Purpose To identify distinct smoking trajectories during adolescence and assess how smoking-related factors relate to trajectory membership. Methods The sample includes 3637 youth from across the state of Minnesota. Measures include tobacco use, smoking behaviors of parents and friends, youth smoking-related attitudes and beliefs, and home smoking policies. A cohort-sequential design was used to identify smoking trajectories, including five cohorts of youth (ages 12–16) followed for 3 years. Results Six distinct trajectories of tobacco use were found: nonsmokers (54%), triers (17%), occasional users (10%), early established (7%), late established (8%), and decliners (4%). Several factors were associated with increased likelihood of being in a smoking trajectory group (vs. the nonsmoking group): parental smoking, friend smoking, greater perceptions of the number of adults and teenagers who smoke, and higher functional meaning of tobacco use. In contrast, higher perceived difficulty smoking in public places, negative perceptions of the tobacco industry, and home smoking policies were associated with less likelihood of being in one of the smoking trajectories (vs. the nonsmoking trajectory). Conclusions Adolescents exhibit diverse patterns of smoking during adolescence and tobacco-related influences were strong predictors of trajectory membership.

Does smoking among friends explain apparent genetic effects on current smoking in adolescence and young adulthood?

We used data from a prospective cohort study of twins to investigate the influence of unmeasured genetic and measured and unmeasured environmental factors on the smoking behaviour of adolescents and young adults. Twins were surveyed in 1988 (aged 11–18 years), 1991, 1996 and 2004 with data from 1409, 1121, 732 and 758 pairs analysed from each survey wave, respectively. Questionnaires assessed the smoking behaviour of twins and the perceived smoking behaviour of friends and parents. Using a novel logistic regression analysis, we simultaneously modelled individual risk and excess concordance for current smoking as a function of zygosity, survey wave, parental smoking and peer smoking. Being concordant for having peers who smoked was a predictor of concordance for current smoking (P<0.001). After adjusting for peer smoking, monozygotic (MZ) pairs were no more alike than dizygotic pairs for current smoking at waves 2, 3 and 4. Genetic explanations are not needed to explain the greater concordance for current smoking among adult MZ pairs. However, if they are invoked, the role of genes may be due to indirect effects acting through the social environment. Smoking prevention efforts may benefit more by targeting social factors than attempting to identify genetic factors associated with smoking.

An investigation of the smoking behaviours of parents before, during and after the birth of their children in Taiwan.

BackgroundAlthough many studies have investigated the negative effects of parental smoking on children and Taiwan has started campaigns to promote smoke-free homes, little is known about the smoking behaviours of Taiwanese parents during the childbearing period. To help fill the gap, this study investigated Taiwanese parents' smoking behaviours before, during and after the birth of their children, particularly focusing on smoking cessation during pregnancy and relapse after childbirth.MethodsWe used data from the Survey of Health Status of Women and Children, conducted by Taiwan's National Health Research Institutes in 2000. After excluding survey respondents with missing information about their smoking behaviours, our sample consisted of 3,109 women who were married at the time of interview and had at least one childbearing experience between March 1, 1995 and February 28, 1999. Data on parental smoking behaviour in the six months before pregnancy, during pregnancy, and in the first year after childbirth were extracted from the survey and analysed by descriptive statistics as well as logistic regression.ResultsFour percent of the mothers and sixty percent of the fathers smoked before the conception of their first child. The educational attainment and occupation of the parents were associated with their smoking status before the first pregnancy in the family. Over 80% of smoking mothers did not quit during pregnancy, and almost all of the smoking fathers continued tobacco use while their partners were pregnant. Over two thirds of the women who stopped smoking during their pregnancies relapsed soon after childbirth. Very few smoking men stopped tobacco use while their partners were pregnant, and over a half of those who quit started to smoke again soon after their children were born.ConclusionAmong Taiwanese women who had childbearing experiences in the late 1990s, few smoked. Of those who smoked, few quit during pregnancy. Most of those who quit relapsed in the first year after childbirth. The smoking prevalence was high among the husbands of these Taiwanese women, and almost all of these smoking fathers continued tobacco use while their partners were pregnant. It is important to advocate the benefits of a smoke-free home to Taiwanese parents-to-be and parents with young children, especially the fathers. The government should take advantage of its free prenatal care and well-child care services to do this. In addition to educational campaigns through the media, the government can request physicians to promote smoke-free homes when they deliver prenatal care and well-child care. This could help reduce young children's health risks from their mothers' smoking during pregnancy and second-hand smoke at home.

Parental smoking behavior and caries experience in preschool children

The study aimed to explore the association between parental smoking behavior and caries experience in young children, taking into account the socioeconomic status and oral health-related behavior. Cross-sectional data from 1250 3-year-old and 1283 5-year-old children from four geographical areas in Flanders (Belgium) were analyzed. Children were examined at school by trained dentist-examiners, using standard criteria and calibrated examination methodology. Data on oral hygiene and dietary habits, oral health behavior, sociodemographic variables, and parental smoking behavior were obtained through structured questionnaires, completed by the parents. Visible caries experience (i.e. d(3)mft > 0) was seen in 7% of 3-year olds and 31% of 5-year olds. In both age groups, 30% of the parents reported smoking behavior. Univariable logistic regression analysis with caries prevalence as the dependent variable, revealed that parental smoking was a significant independent variable. After controlling for age, gender, sociodemographic characteristics, oral hygiene, and dietary habits, the effect of family smoking status was no longer significant in 3-year-old children (OR = 1.98; 95% CI: 0.68-5.76). In 5-year olds the significant relationship between parental smoking behavior and caries experience persisted after adjusting for the other evaluated variables (OR = 3.36; 95% CI: 1.49-7.58). The results of this study illustrate the existence of a significant association between parental smoking behavior and caries experience in 5-year-old children.

Parental smoking behaviour and effects of tobacco smoke on children's health in Finland and Russia

There is little information on potential differences in smoking behaviour of parents between Finland and Russia and on the effects of environmental tobacco smoke (ETS) exposure on allergic and respiratory diseases among Finnish and Russian children. The aim of the study was to compare the smoking behaviour of parents and school children and to assess the relations of tobacco smoke exposure during pregnancy and childhood with occurrence of allergic diseases and respiratory infections among school children. We conducted a population-based cross-sectional study in the neighbour towns across the border of Imatra in Finland and Svetogorsk in Russia. The study population consisted of 512 Finnish and 581 Russian school children aged 7-16 years (response rate 79%). Children's tobacco smoke exposure differed markedly between Finland and Russia. The risk of asthma was particularly related to high maternal smoking exposure during pregnancy (adjusted OR 3.51, 95% CI 1.00-12.3), infancy (3.34, 1.23-9.07) and currently (3.27, 1.26-8.48), and the risk of common cold was related to high combined parental smoking during infancy (1.83, 1.06-3.17) in Finnish children. Among Russian children allergic conjunctivitis was related to maternal smoking during infancy (4.53, 1.49-13.8) and currently (2.82, 1.07-7.44). Smoking behaviour of parents and ETS exposure during childhood differed markedly between Finland and Russia. Asthma was particularly increased in relation to high exposure to maternal smoking in Finland. The results suggest that more efforts should be directed to reducing tobacco smoke exposure of children in both Finland and Russia. (250 words).