Maternal socialization of adolescent smoking: the intergenerational transmission of parenting and smoking

An examination of the associations between depressive symptoms, perceived parental discipline, alcohol use, and drinking-related consequences during the first year of college: A moderated mediation model

Background

Depression is prevalent among adolescents and young adults and is associated with experiencing increased negative alcohol-related consequences; thus, it is imperative to identify malleable protective factors for alcohol risks in young adults experiencing elevated depressive symptoms. The current study longitudinally explored the effects of perceived parental alcohol-related discipline on the relationship between depressive symptoms, alcohol use, and negative drinking consequences during the transition into college.

Methods

Incoming college students (N = 272, 63.2% female) completed web-based surveys before (July, T1) and after (October, T2) the transition into college and reported depressive symptoms, perceived alcohol-related discipline, alcohol use, and consequences of drinking experienced in the past 30 days.

Results

The moderated mediation model revealed that at above average perceptions of alcohol-related discipline, depressive symptoms were negatively associated with alcohol use, which in turn was associated with experiencing fewer negative consequences of drinking.

Limitations

The current study did not measure a diagnosis of major depressive disorder, and therefore our results may differ among clinical populations. In addition, we did not measure other parenting constructs shown to protect students with elevated levels of depressive symptoms from experiencing consequences (i.e., monitoring).

Conclusions

The present findings suggest perceptions of parental alcohol-related discipline measured here (e.g., having a privilege taken away, being scolded or grounded) can be protective against alcohol risks among college students experiencing above average depressive symptoms. Parent-based alcohol interventions administered prior to matriculation should encourage parents of depressed students to clearly communicate consequences for drinking to their child.

The Intergenerational Transmission of Mental and Physical Health in Australia: Evidence Using Data From the Household Income and Labor Dynamics of Australia Survey

Promoting good health across the life course is high on countries agenda. There is a growing evidence base that health is correlated across generations. We examine the persistence of physical and mental health status across generations and explore how different early life factors and adult outcomes impact on this association. In particular, we focus on childhood disadvantage and childhood health, educational attainment, and social mobility measured by household income compared to one's parents. We use data from 19 waves of the Household, Income and Labor Dynamics in Australia (HILDA) Survey. The analysis is restricted to young adults (aged 25-35 years old in 2019) and their parents. We find an intergenerational correlation in health which ranges from 0.19 for physical health to 0.20 for the QALY and 0.21 for mental health. After we include covariates related to childhood disadvantage, childhood health, educational attainment, and social mobility, the intergenerational correlations are reduced to 0.13 for physical health, 0.18 for mental health, and 0.14 for QALYs. We find that early life disadvantage is the only factor influencing the intergenerational correlation for all health measures. Policy focusing on reducing the negative impact of early life disadvantage is likely to have a larger impact on improving health across the life course and reducing intergenerational health inequalities.

Mechanisms Underlying Associations between Media Alcohol Exposure, Parenting, and Early Adolescent Drinking: A Moderated Sequential Mediation Model

Exposure to alcohol content in the media, especially in movies, is a demonstrated risk factor for adolescent alcohol use. This paper examines processes underlying this association and whether parenting mitigates such harms. A mediational model of parental restriction of mature media (W1), alcohol content exposure (W2), alcohol expectancies, peer norms (W3), and alcohol outcomes (W4) was tested using annual assessments from a study of adolescent drinking (N = 879; 52% female; 21% Non-White; 12% Hispanic). When restrictions are not in place, adolescents report greater exposure to alcohol content, leading to higher perceived peer drinking. Parental monitoring did not buffer the link between exposure and peer norms. Parental media restriction and perceptions about peers comprise mechanisms by which alcohol-saturated media influences youth drinking.

Electronic Vaping Product Use among Young Adults Who Receive Care at a Major Medical Institution

Background: National estimates of electronic vaping product (EVP) use exist, but little is known about young adult EVP users who interact with the healthcare setting. Methods: Cross-sectional survey of 18-25 year olds receiving care in our ambulatory medical practice. Population differences were evaluated with the chi square test reporting unadjusted odds ratios (ORs). Results: Response rate was 16.6% (n = 1,017/6,119). The prevalence of ever EVP use was 46.0% of whom 13.9% used every day. Each additional day of alcohol use (past 30 days) was associated with increased odds of being an EVP user (OR = 1.06, 95% CI 1.02-1.09), and cannabis use (past 30 days) was associated with a higher odds of being an EVP user compared to non-cannabis users (OR = 40.0, 95% CI 17.4 - 111.8). Observing a biological parent (OR = 2.89, 95% CI 1.98-4.24), step parent (OR = 2.03, 95% CI 1.02-4.19) and full sibling (OR = 2.31, 95% CI 1.78-3.00) using inhaled substances (past 30 days) was associated with increased odds of being an ever EVP user. Ever EVP users had lower odds than never users to report that EVPs with nicotine are "a little" or "a lot" more harmful than smoking "regular" tobacco cigarettes (OR = 0.53, 95% CI 0.37 - 0.76). Conclusion: Our survey is limited by a low response rate but confirms observed associations between EVP use and substance use and social influences. Our data also suggest that professionals should regularly screen for EVP use among young people, especially those with exposure to family members who used inhaled substances.

Parental Awareness of Youth Tobacco Use and the Role of Household Tobacco Rules in Use Prevention

BACKGROUND AND OBJECTIVES

Noncigarette tobacco use is increasing. In this study, we reexamined (1) parental knowledge or suspicion of their children's tobacco use and (2) associations of household tobacco-free rules with youth initiation.

METHODS

Participants were youth (aged 12-17) in waves 1 to 4 (2013-2018) of the Population Assessment of Tobacco and Health Study. A pseudo cross-sectional time-series analysis (N = 23 170) was used to examine parent or guardian knowledge or suspicion of their child's tobacco use according to youth-reported use categories: cigarette only, electronic cigarette only, smokeless tobacco only, noncigarette combustible only, and poly use. A longitudinal analysis among wave 1 never users (n = 8994) was used to examine rules barring tobacco inside the home and whether parents talked with youth about not using tobacco as predictors of youth tobacco initiation after 1 to 3 years. Survey-weighted multivariable models were adjusted for tobacco use risk factors.

RESULTS

In all waves, parents or guardians much less often knew or suspected that their children used tobacco if youth only reported use of electronic cigarettes, noncigarette combustible products, or smokeless tobacco compared with cigarettes. Youth tobacco initiation was lower when youth and parents agreed that rules prohibited all tobacco use throughout the home (1-year adjusted odds ratio: 0.74; 95% confidence interval: 0.59-0.94) but not when parents talked with youth about tobacco (adjusted odds ratio: 1.08; 95% confidence interval: 0.94-1.23).

CONCLUSIONS

Many parents are unaware of their children's noncigarette tobacco use. Setting expectations for tobacco-free environments appears more effective at preventing youth tobacco initiation than parents advising children not to use tobacco.

Exploring Cannabis-Specific Parenting as a Mechanism of the Intergenerational Transmission of Cannabis Use and Cannabis Use Disorder

OBJECTIVE

Parental cannabis use disorder (CUD) is a known risk factor in the development of adolescent cannabis use. One potential mechanism is parenting behaviors. This study considered cannabis-specific parenting strategies as a mechanism of the relation between parental CUD and adolescent cannabis use.

METHOD

Pathways were examined using multilevel longitudinal mediation models (N = 363, mean age = 16.3 years) comparing adolescent offspring of parents who never used cannabis, parents who used cannabis without CUD, and parents with CUD.

RESULTS

Parental cannabis use history did not significantly predict parental sharing of negative experiences with cannabis or parental strategies to prevent cannabis use. Cannabis-specific strategies did not successfully deter adolescent use. Parental sharing of negative experiences with cannabis use in fact predicted increased adolescent cannabis use.

CONCLUSIONS

Cannabis-specific parenting did not reduce adolescent cannabis use, and sharing negative experiences was detrimental. Future studies should consider alternative mechanisms underlying the intergenerational transmission of cannabis use.

Smokers with children with asthma: Parental perceptions about prototype intervention messages focused on reducing child tobacco exposure and use

Formative research is needed to develop effective interventions that eliminate secondhand smoke exposure (SHSe) and prevent tobacco use (TU) among children with asthma. This online study included 300 parents who smoke and had a child with asthma (ages 10-14) and evaluated their perceptions about prototypes of parent-directed and child-directed feedback intervention messages focused on reducing child SHSe and future TU; correlates of perceptions were explored. Parents rated examples of parent-directed messages on motivation and helpfulness for eliminating SHSe and promoting conversations about TU and also rated child-directed messages on acceptability and helpfulness for promoting conversations about TU. Messages differed by level of personalization, theoretical background, or message content. Parents found all parent-directed messages similarly motivating and helpful and all child-directed messages similarly acceptable and helpful for reducing child tobacco exposure. Differences in perceptions about feedback emerged based on parent gender, parent readiness to quit, smoking ban status, and the presence of additional smokers in the home. Overall, parents rated parent-directed and child-directed feedback message prototypes positively, including established and novel types of feedback. Parent-child feedback interventions may hold promise for breaking the intergenerational transmission of smoking among families with a parent who smokes and a child with asthma.

A Longitudinal Analysis of the Intergenerational Transmission of Health Inequality

Objectives

Empirical investigations of cumulative dis/advantage typically treat health inequality as an intraindividual process rooted in early-life conditions and operating within the span of the individual life course, while literature on processes of intergenerational transmission has historically focused on socioeconomic mobility, largely overlooking health. The current study examines the persistence of work disability across generations and multiple explanations for this relationship, including the role of early-life disadvantage, childhood health, educational attainment, and social mobility.

Methods

We model latent classes of midlife work disability characterized by timing and stability using longitudinal data from the intergenerational component of the U.S. Panel Study of Income Dynamics (N = 3,328). Latent class analysis captures the initial risk of experiencing a work disability and how this risk changes across mid-life as a function of early-life conditions, childhood health, educational attainment, mobility, and parent's work disability.

Results

Early disadvantage, childhood health, and educational attainment were associated with patterns of midlife work disability, and although upward mobility provided some protection, intergenerational continuity in health remained net of all of these factors.

Discussion

Findings support the importance of looking beyond the individual life course to the transmission of health inequality across generations within families.

Parental drinking as context for parental socialization of adolescent alcohol use

INTRODUCTION

While alcohol-specific parenting practices have demonstrated unique effects on adolescent substance use, their efficacy in the context of parental drinking levels has not been studied. This study assessed the influence of three alcohol-specific parenting practices (rules, punishment, communication) on adolescent alcohol use, and the degree to which those associations varied by parents' own drinking.

METHODS

We conducted logistic regression analyses among US adolescents (N = 1023; 52% female; 12% Hispanic; 76% Caucasian, 5% Black, 8% mixed race, 11% other race/ethnicity; mean age at enrollment = 12.2 years) to examine the relationship between alcohol-specific parenting practices and the odds of ever having experienced two drinking milestones, having a full drink of alcohol and a heavy drinking episode, and whether parental drinking levels moderated those associations.

RESULTS

Strict rules for drinking, higher levels of cautionary communication messages, and punishment for drinking were associated with lower odds of alcohol use. Witnessing parent drinking increased the risk for both alcohol outcomes. Furthermore, parental drinking modified the influence of parental cautionary messages on alcohol use such that the effect was particularly salient for those youth who witnessed and whose parents reported higher levels of alcohol use.

CONCLUSIONS

Family-based preventive interventions should include skills training in alcohol-specific parenting practices with emphasis on reducing parental alcohol use particularly when children are present.

Adolescent recanting of alcohol use: A longitudinal investigation of time-varying intra-individual predictors

BACKGROUND

Recanting - denying previous reports of lifetime substance use - occurs frequently in longitudinal investigations of adolescent substance use. While research has focused on how individual differences contribute to recanting, intra-individual factors associated with recanting over time remain understudied.

METHODS

Adolescents (n = 1023) were assessed six times between 2009 - 2015. The sample included participants who reported ever-sipping alcohol in at least one assessment who maintained or recanted ever-sipping at the subsequent assessment (n = 543, 53.1% of full sample; 54.5% female; 84.9% white; 89.5% non-Hispanic). The majority (58.6%) of the sample recanted ever-sipping. We fit linear mixed models to investigate whether prospective changes in perceived peer drinking, peer approval, alcohol expectancies, and fear of reprisal predicted recanting. To explore whether mechanisms of recanting differed for delayed (i.e., two assessments or later) recanting, we refit the models in a subset of data excluding immediate (i.e., subsequent assessment) recanters.

RESULTS

Prospective increases in perceived peer drinking (OR = 0.65), peer approval of drinking (OR = 0.82), and positive and negative alcohol expectancies (OR = 0.96; 0.98, respectively) predicted lower odds of recanting. Similar effects were observed among only delayed recanters.

CONCLUSION

Time-varying, intra-individual factors uniquely predicted recanting over time. Although most recanting occurs immediately following the initial report of ever-sipping, the observed effects were consistent between delayed recanters and the sample as a whole. Considering the systematic patterns evident in recanting, researchers should consider using computer-assisted or other research methods that minimize or verify recanting when it occurs while also informing missing data models.

Parental transmission of smoking among middle-aged and older populations in Russia and Belarus

OBJECTIVES

The very high rates of smoking among men and the rapid changes among women in the Post-Soviet countries mean that this region offers an opportunity to understand better the intergenerational role of parental influences on smoking.

METHODS

In this study, we exploit a unique data set, the PrivMort cohort study conducted in 30 Russian and 20 Belarusian towns in 2014-2015, which collects information on behaviours of middle-aged and older individuals and their parents, including smoking. We explored the associations between smoking by parents and their offspring using multiply imputed data sets and multilevel mixed-effect Poisson regressions.

RESULTS

Adjusting for a wide array of social origin, socio-demographic, and socio-economic variables, our analysis suggests that sons of regularly smoking fathers have prevalence ratios of 1.35 [95% confidence intervals (CI) 1.21-1.50] and 1.39 (CI 1.23-1.58) of smoking, while the figures for daughters of regularly smoking mothers are 1.91 (CI 1.40-2.61) and 2.30 (CI 1.61-3.28), respectively, in Russia and Belarus.

CONCLUSIONS

Intergenerational paternal and maternal influences on smoking should be taken into account in studies seeking to monitor the rates of smoking and the impact of tobacco control programmes.

Alteration of adolescent aversive nicotine response and anxiety-like behavior in nicotine-exposed rats during late lactation period

Early nicotine exposure is an important cause of further habitual tobacco smoking. Although nicotine has not only rewarding but also aversive properties, the effects of early nicotine exposure on the distinct properties of nicotine are not well known. To reveal the effects of early adolescent nicotine exposure on further persistent tobacco smoking, we demonstrated developmental changes in nicotine-related appetitive and aversive behaviors of rats exposed to nicotine during the late lactation period. Sprague-Dawley rats were injected with saline or nicotine (2, 6 and 12mg/kg). We performed a two bottle free-choice test using escalating doses of nicotine (25, 50 and 100μg/ml), saccharin and quinine and the open field test in both adolescent and adult rats. The rats' aversive response to nicotine was increased according to the increase in nicotine concentration. Adolescent rats showed higher nicotine preference and consumption behaviors than did adult rats at an aversive dose of nicotine. Nicotine-exposed rats increased adolescent nicotine consumption when the nicotine concentration was 12mg/kg. We observed significant increases in anxious behaviors in adolescent nicotine-injected rats compared to saline-injected rats, but there were no alterations in adult rats. In both adolescent and adult rats, saccharin and quinine intake were not significantly different between groups. Taken together, it suggests that repeated nicotine exposure in late lactation period affect changes in aversive nicotine responses and anxious behaviors during adolescence but there is no difference in adults.

Providing Antismoking Socialization to Children After Quitting Smoking: Does It Help Parents Stay Quit?

PURPOSE

To test whether an antismoking parenting program provided to parents who had quit smoking for ≥24 hours increased parents' likelihood of remaining abstinent 2 and 3 years postbaseline.

DESIGN

Two-group randomized controlled trial with 3-year follow-up.

SETTING

Eleven states (Colorado, Indiana, Michigan, Minnesota, Montana, New York, Ohio, Pennsylvania, South Dakota, Utah, and Vermont).

PARTICIPANTS

Five hundred seventy-seven adults (286 treatment and 291 control) who had smoked ≥10 cigarettes daily at baseline, had quit smoking for ≥24 hours after calling a Quitline, and were parents of an 8- to 10-year-old child; 358 (62%) completed the 2-year follow-up interview, and 304 (53%) completed the 3-year follow-up interview.

INTERVENTION

Theory-driven, home-based, self-help parenting program.

MEASURES

Sociodemographic, smoking history, and 30-day point prevalence.

ANALYSIS

Multivariable regression analyses tested for group differences in 30-day abstinence. Attriters were coded as having relapsed.

RESULTS

Between-group differences in abstinence rates were 5.6% and 5.9% at 2 and 3 years, respectively. Treatment group parents had greater odds of abstinence, an effect that was significant only at the latter time point (odds ratio [OR] = 1.49, P = .075 at 2 years; OR = 1.70, P = .026 at 3 years).

CONCLUSIONS

This study obtained preliminary evidence that engaging parents who recently quit smoking as agents of antismoking socialization of children has the potential to reduce the long-term odds of relapse.

What parents can do to keep their children from smoking: A systematic review on smoking-specific parenting strategies and smoking onset

AIM

To provide a systematic overview of longitudinal studies on different smoking-specific parenting practices (i.e., perceived parental norms and influences, smoking-specific monitoring, availability of cigarettes at home, household smoking rules, non-smoking agreements, smoking-specific communication, and parental reactions) as useful tools in the prevention of youth smoking.

METHOD

MEDLINE and PsychINFO search identified 986 studies published from 1990 to December 2016. Two independent researchers identified eligible studies. Study quality was assessed using Newcastle Ottawa Scale (NOS).

RESULTS

The systematic search resulted in 1 to 14 longitudinal studies per parenting practice. Studies scored between 4 and 9 on the NOS, indicating an overall moderate quality. The results of complete smoking house rules showed a preventive effect on smoking onset. Furthermore, availability of cigarettes, frequency and quality of communication, parental reaction (i.e., conflict engagement) and norms showed significant and non-significant effects. Significant results were in line with expectations: availability of cigarettes and frequent communication about smoking predicted smoking, whereas a high quality of communication, negative reactions or punishments and setting norms by parents showed a preventive effect. No effects were found for non-smoking agreements. The number of studies was too limited to draw conclusions about other parenting strategies. More research on (1) reliable and valid instruments, (2) other stages of smoking in addition to onset, and (3) potential moderators and mediators is warranted.

CONCLUSION

While evidence supports the effectiveness of smoking-specific parenting, further research is required.

Daughters of Mothers Who Smoke: A Population-based Cohort Study of Maternal Prenatal Tobacco use and Subsequent Prenatal Smoking in Offspring

BACKGROUND

Prenatal exposure to tobacco is associated with adverse health outcomes for the mother and child, and has been associated with an increased risk of tobacco smoking and nicotine dependence in offspring. The objective of this study was to examine the risk of prenatal smoking, among daughters, associated with maternal prenatal smoking.

METHODS

We used a population-based cohort study design, with linked vital records data of mothers and daughters delivering 1984-96 and 1996-2013, respectively, in Washington State. The exposure of interest was mothers' prenatal smoking (any vs. no smoking at any time during pregnancy), while the outcome was daughters' prenatal smoking (similarly assessed). We used multivariable log-binomial regression to obtain estimates of the relative risk (RR) and 95% confidence interval (CI).

RESULTS

Daughters exposed to maternal prenatal smoking were more likely to smoke during their pregnancy, compared to unexposed daughters (RR 1.78, 95% CI 1.72, 1.84, adjusted for the year the daughter delivered, her marital status and educational attainment, and the mothers' race/ethnicity).

CONCLUSIONS

In this relatively young population, we found that daughters exposed to maternal prenatal smoking have an increased risk of smoking later on during their own pregnancy, emphasizing the importance of exposures during the prenatal period. The mechanisms leading to prenatal smoking are multifactorial and likely include behavioural, genetic, epigenetic and environmental factors. An understanding of this risk factor for prenatal smoking may guide health care providers to better target smoking cessation interventions to at-risk populations.

Engaging parents of children with and without asthma in smoking-specific parenting: results from a 3-year Randomized Controlled Trial evaluation

The present study evaluated long-term effects of a home-based smoking prevention program targeting smoking-specific parenting in families with children with and without asthma. A total of 1398 non-smoking children (mean age 10.1) participated, of which 197 (14.1%) were diagnosed with asthma. Families were blinded to group assignment. The intervention group (n = 684) received booklets with assignments that actively encouraged parents to engage in smoking-specific parenting strategies. Control families (n = 714) received booklets containing basic information about youth smoking. Latent growth curve modeling was used to calculate intercepts and slopes to examine whether there was change in the different parenting aspects over the study period. Regression analyses were used to examine whether a possible change was different for intervention and control condition families with and without a child with asthma. For those smoking-specific parenting aspects that changed over time, families in the intervention and control condition increased similarly. Families with a child with asthma did not engage in parenting at higher levels due to the intervention program than parents of non-asthmatic children. This prevention program did not affect smoking-specific parenting in the Netherlands. Future prevention research could focus on other risk factors for smoking initiation among adolescents with asthma.

TRIAL REGISTRATION

Netherlands Trial Register NTR1465.

Maternal age and offspring health and health behaviours in late adolescence in Sweden

In this study we investigate the relationship between maternal age at the time of birth and a variety of health behaviours and measures of health amongst young adults in contemporary Sweden. Previous research has shown that those born to younger and older mothers tend to have worse perinatal outcomes, and worse health in middle- and later adulthood. However, previous work has not examined health in early adulthood, and no studies have explored whether maternal age is related to health behaviours. Using survey data on 1236 19-year olds born in Sweden in 1990, we find that those born to older mothers have lower self-rated health, are more likely to smoke, more likely to drink alcohol regularly, and less likely to exercise regularly. We discuss potential explanations for these findings, such as older parents exerting lower social control due to greater levels of workplace responsibilities and time demands, long-term consequences of the poor peri-natal outcomes of those born to older mothers, as well as the potential role of parental health behaviours. Our findings suggest that health behaviours may play an important mediating role in explaining the worse long-term health of those born to younger and older mothers.

Parental and adolescent health behaviors and pathways to adulthood

This paper examines associations among parental and adolescent health behaviors and pathways to adulthood. Using data from the National Longitudinal Study of Adolescent to Adult Health, we identify a set of latent classes describing pathways into adulthood and examine health-related predictors of these pathways. The identified pathways are consistent with prior research using other sources of data. Results also show that both adolescent and parental health behaviors differentiate pathways. Parental and adolescent smoking are associated with lowered probability of the higher education pathway and higher likelihood of the work and the work & family pathways (entry into the workforce soon after high school completion). Adolescent drinking is positively associated with the work pathway and the higher education pathway, but decreases the likelihood of the work & family pathway. Neither parental nor adolescent obesity are associated with any of the pathways to adulthood. When combined, parental/adolescent smoking and adolescent drinking are associated with displacement from the basic institutions of school, work, and family.

Examining the Perspectives of Texas Minors Cited for Possession of Tobacco

This study examined the personal experiences of twenty 14-to-19-year-old Texas youth cited for tobacco possession and attending a court-mandated tobacco awareness class. Guided by labeling theory, focus group questions addressed the process of citation, how youth viewed themselves following citation, how parents and peers viewed youth following citation, and youths’ views on the purpose and effects of the policy. Many youth felt stupid for being caught or determined that they were unlucky. Parents were upset that youth were caught smoking; however, most knew their children smoked. Peers felt sympathy for cited youth or made fun of them for being caught. Participants felt that the law was in existence to deter younger children from initiating smoking or to encourage older minors to quit smoking. However, youth also indicated that there was no purpose to the law and that instead of decreasing smoking it could lead to its continuation. Implications for practice are discussed.

Profiles of Maternal Parenting Practices: Exploring the Link With Maternal Delinquency, Offending, Mental Health, and Children's Physical Aggression

Studies have often linked parenting to children's subsequent antisocial behavior; however, the circumstances under which this might occur are less clear. The current study explores patterns in mothers' parenting practices, and associated correlates including maternal delinquency and offending, mental health, and children's physical aggression. This study is based on the first wave of the ongoing Vancouver Longitudinal Study; the objective of this prospective study is to identify the early risk and protective factors for aggression and violence from the earliest developmental periods. Parenting practices of 287 mothers with preschoolers are examined using a series of latent class analyses. Three different patterns of parenting emerged: Positive, Negative, and Intermittent. Patterns identified are associated with several key criminogenic, socio-demographic, historical, and developmental factors including current maternal adult offending, mothers' mental health, ethnicity, and frequency of children's physical aggression. Importantly, mothers who show parenting in line with the more negative classes also rely on a number of positive practices. Implications of the study suggest that parenting is influenced by mothers' immediate situations and contexts (e.g., current offending rather that past delinquency), which can be targeted for intervention.

Parent voices guide smoking intervention development

Purpose

– While parents’ influence on their children’s smoking behaviour is widely recognised, little is known about parents of four to eight year olds’ attitudes and beliefs around smoking cessation and how they communicate with their children about smoking. The purpose of this paper is to explore parents’ perceptions of quitting smoking and their beliefs and actions related to the use of parenting practices to discourage smoking by their children.

Design/methodology/approach

– Four focus groups and 17 interviews were conducted with parents (n=46) of four to eight year old children in Perth, Western Australia.

Findings

– Many parents indicated their children strongly influenced their quitting behaviours, however, some resented being made to feel guilty about their smoking because of their children. Parents were divided in their beliefs about the amount of influence they had on their children’s future smoking. Feelings of hypocrisy appear to influence the extent to which parents who smoked talked with their child about smoking. Parents recommended a variety of resource options to support quitting and talking with their child about smoking.

Practical implications

– Interventions aimed at parents who smoke and have young children should: reinforce parents’ importance as role models; highlight the importance of talking to children about smoking when they are young and provide strategies for maintaining ongoing communication; be supportive and avoid making parents feel guilty; and emphasise that quitting smoking is the best option for their child’s health (and their own), while also providing effective harm minimisation options for parents who have not yet quit.

Originality/value

– Parents of children of lower primary school age can be highly influential on their children’s later smoking behaviours, thus, effective interventions that address the current beliefs and practices of these parents may be particularly advantageous.

Brief Family Based Intervention for Substance Abusing Adolescents

Research has shown that a lack of parental involvement in their children's activities predicts initiation and escalation of substance use. Parental monitoring and supervision, parent-child communication including communication regarding beliefs and disapproval of substance use, positive parenting, and family management strategies, have been shown to protect against adolescent substance abuse and related problems. Family and parenting approaches to preventing and intervening on adolescent substance abuse have received support in the literature. This article discusses the theoretical foundations as well as the application of the Family Check-up, a brief, family-based intervention for adolescent substance use.

Prevalence and correlates of sipping alcohol in a prospective middle school sample

Research documents an association between early use of alcohol and adverse outcomes. Most studies on drinking initiation exclude sipping or confound sips with consumption of a full drink. However, even a few sips of alcohol can constitute a meaningful experience for naïve drinkers. Prior research with this project indicated that sipping before middle school predicted subsequent adverse outcomes (at high-school entry), even controlling for child externalizing and sensation seeking and parent alcohol use. The present study extends our prior work by examining the correlates of early sipping and sipping onset. The sample was comprised of 1,023 6th, 7th, and 8th graders (52% female; 24% non-White, and 12% Hispanic). Participants completed Web-based surveys on 5 occasions over the course of 2 years. The prevalence of sipping at Wave 1 was 37%, with 29% of never-sippers initiating sipping within 2 years. Sipping was associated with stronger alcohol-related cognitions and low school engagement as well as contextual influences in the peer, sibling, and parent domains. Sipping onset among never-sippers was prospectively predicted by sensation seeking and problem behavior as well as parental and sibling influences. More important, mere availability of alcohol was a strong correlate both concurrently and prospectively. Further analyses demonstrated that youth who sipped alcohol with parental permission had a lower profile of risk and healthier relationships with parents as compared with youth who reported unsanctioned sipping. Findings point to the importance of considering fine-grained early drinking behavior and call for further attention to sipping in research on initiation of alcohol use.

Parental-adolescent drug use discussions: physiological responses and associated outcomes

PURPOSE

Although talking to youth about drugs is often recommended to parents, we know little about how parents actually discuss drugs with their children in the moment and how parental advice is linked to youth arousal and substance use. This study examined observed parental drug use advice and parenting behaviors during parent-adolescent drug use discussions and associations with adolescent physiological responses and substance use.

METHODS

Fifty-eight 12-17 year olds and their primary caregivers participated in a laboratory session in which parents and youth discussed the topic of alcohol and/or drug use for 10 minutes. This discussion was videotaped and coded for drug use advice (rules against drug use, information on drug use consequences, scenarios or learning advice [discussing drug use scenarios and what the child has learned about drugs]) and general parenting behaviors (parental warmth and/or support, negative and/or critical parenting). Before, during, and after the discussions, adolescents' heart rate, blood pressure (BP), and salivary cortisol levels were assessed.

RESULTS

Parental discussion of scenarios and/or learning was associated with lower adolescent BP responses to the discussions and lower likelihood of substance use. Parental discussion of rules against drug use was associated with higher heart rate and BP responses and greater likelihood of substance use. Criticism and/or negative parenting was associated with higher cortisol responses and greater likelihood of substance use at a trend level.

CONCLUSIONS

Parenting characterized by greater discussion of drug use scenarios and less stating of rules against drug use and criticism may make youth feel more comfortable and be linked to lower substance use.

A latent growth curve analysis of alcohol-use specific parenting and adolescent alcohol use

This study investigates how changes in alcohol use-specific parenting were associated with adolescent drinking trajectories. Three waves of data from a longitudinal study investigating adolescent substance use were used. The community sample (N=378) was aged 10-13 at the first wave of assessment. Our findings show that over time, parents are less likely to discipline their adolescents' drinking, more likely to grant their adolescent permission to drink, and less likely to communicate the consequences of alcohol use. Moreover, these changes are associated with escalation in adolescent alcohol use. Parental efficacy at preventing alcohol use declined, but did not relate to changes in adolescent drinking.

Hong Kong Chinese adolescents' self-reported smoking and perceptions of parenting styles

BACKGROUND

Adolescent smoking has been associated with general parenting style, although potential differences between fathers and mothers were seldom investigated, especially in non-Western populations.

PURPOSE

The aim of this study is to investigate associations between Hong Kong adolescents' smoking and their perceptions of paternal and maternal parenting styles.

METHOD

In a school-based survey in 2006-2007, 33,408 adolescents (44.6 % boys; mean age 14.5 ± 1.3 years) provided information on smoking and the frequency of care and control by each parent, who was classified into one of four adolescent-reported parenting styles: authoritative (high care, high control), authoritarian (low care, high control), permissive (high care, low control), or neglectful (low care, low control). Logistic regression was used to calculate adjusted odds ratios (AORs) of current smoking (past 30 days) for parenting variables, considering potential effect modification by age, sex and parental smoking.

RESULTS

Maternal care and control were strongly and significantly associated with lower odds of adolescent current smoking. However, such association was weak for paternal care and observed only in girls. Conversely, paternal control was positively associated with current smoking, especially if the father smoked. The lowest AORs of current smoking were associated with authoritative mothers, permissive fathers and combinations of maternal and paternal parenting styles with an authoritative mother whether or not the father was authoritative.

CONCLUSION

Maternal care, control and authoritative parenting were associated with lower odds of adolescent smoking in Hong Kong. Paternal care was only weakly associated with lower odds of adolescent smoking, and paternal control was even associated with higher odds of smoking.

Protecting children from taking up smoking: parents' views on what would help

ISSUE ADDRESSED

The present study investigated what factors the parents of children in low-income areas of Auckland, New Zealand, thought could help protect their children from smoking initiation.

METHODS

Participants in a large quasi-experimental trial that tested a community-, school- and family-based smoking-initiation intervention were asked in a questionnaire 'What could we do to help you protect your children from smoke and taking up smoking?' Free-text responses were divided into distinct meaning units and categorised independently by two of the researchers.

RESULTS

1806 participants (70% of parents who returned the questionnaire) completed the question. The majority of respondents (80%) were either Pacific Island or Māori mothers and 25% were current smokers. Five main categories of suggested strategies for preventing smoking initiation were identified: building children's knowledge of the ill-effects of smoking; denormalising smoking; reducing access to tobacco; building children's resilience; and health promotion activities. The most common suggestion was to educate children about smoking.

CONCLUSION

Building children's knowledge of smoking risks was the main strategy parents proposed. There was some support for banning smoking in most public areas and for tougher moves to stop tobacco sales to minors. Few parents suggested innovative or radical strategies, such as banning the sale of tobacco, fining children for smoking or use of competitions. So what? To ensure reductions in smoking initiation for lower socioeconomic and Māori and Pacific Island people, further research should engage Māori, Pacific Island and lower socioeconomic parents in a process that elicits innovative thinking about culturally acceptable strategies.

Parental smoking exposure and adolescent smoking trajectories

OBJECTIVE

In a multigenerational study of smoking risk, the objective was to investigate the intergenerational transmission of smoking by examining if exposure to parental smoking and nicotine dependence predicts prospective smoking trajectories among adolescent offspring.

METHODS

Adolescents (n = 406) ages 12 to 17 and a parent completed baseline interviews (2001-2004), and adolescents completed up to 2 follow-up interviews 1 and 5 years later. Baseline interviews gathered detailed information on parental smoking history, including timing and duration, current smoking, and nicotine dependence. Adolescent smoking and nicotine dependence were assessed at each time point. Latent Class Growth Analysis identified prospective smoking trajectory classes from adolescence into young adulthood. Logistic regression was used to examine relationships between parental smoking and adolescent smoking trajectories.

RESULTS

Four adolescent smoking trajectory classes were identified: early regular smokers (6%), early experimenters (23%), late experimenters (41%), and nonsmokers (30%). Adolescents with parents who were nicotine-dependent smokers at baseline were more likely to be early regular smokers (odds ratio 1.18, 95% confidence interval 1.05-1.33) and early experimenters (odds ratio 1.04, 95% confidence interval 1.04-1.25) with each additional year of previous exposure to parental smoking. Parents' current non-nicotine-dependent and former smoking were not associated with adolescent smoking trajectories.

CONCLUSIONS

Exposure to parental nicotine dependence is a critical factor influencing intergenerational transmission of smoking. Adolescents with nicotine-dependent parents are susceptible to more intense smoking patterns and this risk increases with longer duration of exposure. Research is needed to optimize interventions to help nicotine-dependent parents quit smoking early in their children's lifetime to reduce these risks.

General and substance-specific predictors of young adult nicotine dependence, alcohol use disorder, and problem behavior: replication in two samples

BACKGROUND

This paper presents two replications of a heuristic model for measuring environment in studies of gene-environment interplay in the etiology of young adult problem behaviors.

METHODS

Data were drawn from two longitudinal, U.S. studies of the etiology of substance use and related behaviors: the Raising Healthy Children study (RHC; N=1040, 47% female) and the Minnesota Twin Family Study (MTFS; N=1512, 50% female). RHC included a Pacific Northwest, school-based, community sample. MTFS included twins identified from state birth records in Minnesota. Both studies included commensurate measures of general family environment and family substance-specific environments in adolescence (RHC ages 10-18; MTFS age 18), as well as young adult nicotine dependence, alcohol and illicit drug use disorders, HIV sexual risk behavior, and antisocial behavior (RHC ages 24, 25; MTFS age 25).

RESULTS

Results from the two samples were highly consistent and largely supported the heuristic model proposed by Bailey et al. (2011). Adolescent general family environment, family smoking environment, and family drinking environment predicted shared variance in problem behaviors in young adulthood. Family smoking environment predicted unique variance in young adult nicotine dependence. Family drinking environment did not appear to predict unique variance in young adult alcohol use disorder.

CONCLUSIONS

Organizing environmental predictors and outcomes into general and substance-specific measures provides a useful way forward in modeling complex environments and phenotypes. Results suggest that programs aimed at preventing young adult problem behaviors should target general family environment and family smoking and drinking environments in adolescence.

Alcohol and tobacco use among maltreated and non-maltreated adolescents in a birth cohort

AIMS

This study examines whether child maltreatment experience predicts adolescent tobacco and alcohol use.

METHODS

The subjects were participants in the Mater-University Study of Pregnancy (MUSP), a birth cohort of 7223, of whom 5158 (71.4%) were available for analysis at the 14-year follow-up. Child protection history was obtained from the state's child protection agency and confidentially linked. Exposure to reported child maltreatment was the primary predictor variable. The outcome variables were self-reported smoking and alcohol use. Associations were adjusted for potential confounders.

RESULTS

Reported child maltreatment was associated with early adolescent smoking [odds ratio (OR) 1.76, 95% confidence interval (CI) = 1.32-2.34] after adjustment for socio-demographic variables and coexisting alcohol use. Both neglect/emotional abuse (OR 2.03, 95% CI = 1.20-3.42) and neglect/emotional abuse that included physical abuse (OR 1.85, 95% CI = 1.19-2.88) were associated with smoking after full adjustment, including for coexisting alcohol use. After full adjustment, including coexisting smoking, only child neglect/emotional abuse predicted early adolescent alcohol use (OR 1.78, 95% CI = 1.06-2.97), but not the other types of maltreatment.

CONCLUSIONS

Reported child maltreatment predicts early adolescent smoking after adjusting for alcohol use, but does not predict alcohol use after adjustment for smoking. Both smoking and alcohol use are predicted by reported child neglect. Early adolescent smoking is also predicted by multi-type maltreatment that includes physical abuse.

Alcohol-specific parenting as a mechanism of parental drinking and alcohol use disorder risk on adolescent alcohol use onset

OBJECTIVE

The primary aim of the current study was to examine three dimensions of alcohol-specific parenting (anti-alcohol parenting strategies, parental legitimacy in regulating adolescent drinking, and parental disclosure of negative alcohol experiences) as mechanisms in the prospective relations between parental drinking and alcohol use disorder (recovered, current, and never diagnosed) and adolescent alcohol use initiation.

METHOD

Participants were from an ongoing longitudinal study of the intergenerational transmission of alcoholism. Structural equation modeling was used to test a maternal model (n = 268 adolescents and their mothers) and a paternal model (n = 204 adolescents and their fathers) of alcohol-specific parenting.

RESULTS

Results indicated that higher levels of drinking among mothers and current alcohol use disorder among fathers were related to more frequent parental disclosure of personal negative experiences with alcohol. Maternal disclosure of negative alcohol experiences mediated the effect of maternal drinking on adolescent onset of alcohol use such that more disclosure predicted a greater likelihood of adolescent drinking initiation at follow-up over and above general parenting. In addition, currently alcoholic mothers were perceived as having less legitimate authority to regulate adolescent drinking, and low levels of legitimacy among fathers was predictive of drinking onset among adolescents.

CONCLUSIONS

Alcohol-specific parenting is a distinct and influential predictor of adolescent alcohol use initiation that is partially shaped by parents' own drinking experiences. Moreover, parental conversations about their own personal experiences with alcohol may not represent a form of parent-child communication about drinking that deters adolescent drinking.

Smoking stage relations to peer, school and parental factors among secondary school students in Kinta, Perak

BACKGROUND

To identify the prevalence of different stages of smoking and differences in associated risk factors.

MATERIALS AND METHODS

Thos longitudinal study started in February 2011 and the subjects were 2552 form one students aged between twelve to thirteen years of from 15 government secondary schools of Kinta, Perak. Data on demographic, parental, school and peer factors were collected using a self-administered questionnaire. We examined the effects of peer, school and parental factors on the five stages of smoking; never smokers, susceptible never smokers, experimenters, current smokers and ex-smokers, at baseline.

RESULTS

In the sample, 19.3% were susceptible never smokers, 5.5% were current smokers 6% were experimenters and 3.1% were ex-smokers. Gender, ethnicity, best friends' smoking status, high peer pressure, higher number of relatives who smoked and parental monitoring were found to be associated with smoking stages. Presence of parent-teen conflict was only associated with susceptible never smokers and experimenters whereas absence of home discussion on smoking hazards was associated with susceptible never smokers and current smokers.

CONCLUSIONS

We identified variations in the factors associated with the different stages of smoking. Our results highlight that anti-smoking strategies should be tailored according to the different smoking stages.

Tobacco use habits among Swedish female youth athletes and the influence of the social environment

AIM

This study examined the prevalence of tobacco habits and the influence of the social environment among Swedish female athletes representing both individual and team sports in Sweden.

MATERIAL AND METHOD

A self-reported cross-sectional survey was performed with 791 female athletes 15-24 years old representing ten of the most common sports in Sweden. The questions related to the participants' involvement in sports and their tobacco habits.

RESULTS

Findings revealed that a large proportion of the female athletes had never smoked (65%) or used snus (74%). However, a considerable portion of the participants had tried smoking (27%) or using snus (20%), especially those involved in team sports. Results also showed statistically significant associations between female athletes' smoking habits and those of both their mothers and their peers, but not with the tobacco habits of their coaches, indicating that coaches do not influence the female athletes' use of tobacco.

CONCLUSION

In conclusion, this study indicated that the vast majority of female athletes did not use tobacco. A significant portion had sometimes tried tobacco, especially members of team sports, but this behaviour did not seem to be influenced by the tobacco habits of their coaches.

Authoritative parenting and cigarette smoking among multiethnic preadolescents: the mediating role of anti-tobacco parenting strategies

INTRODUCTION

Parenting has been shown to affect smoking among children in U.S. majority groups, but less is known about this association among multiethnic urban populations. Our study examines the role of parenting on smoking among a highly diverse sample.

METHODS

Health surveys were collected from eighth graders (N = 459) in 2 low-income urban schools. Structural equation models examined the direct and indirect effects of authoritative parenting on lifetime smoking. A moderated mediation analysis examined whether indirect effects of authoritative parenting vary among racial/ethnic groups.

RESULTS

Authoritative controlling parenting, characterized by limit setting, was positively associated with anti-tobacco parenting. Anti-tobacco parenting was inversely associated with smoking, mediating the relationship between controlling parenting and smoking. There was no evidence that mediation was moderated by race/ethnicity.

CONCLUSIONS

Parent training, which focuses on setting rules and expectations, can be an important and universal element of smoking prevention programs targeted to youth in diverse communities.

Point and click, carefully: investigating inconsistent response styles in middle school and college students involved in web-based longitudinal substance use research

This study investigated inconsistent responding to survey items by participants involved in longitudinal, web-based substance use research. We also examined cross-sectional and prospective predictors of inconsistent responding. Middle school (N = 1,023) and college students (N = 995) from multiple sites in the United States responded to online surveys assessing substance use and related variables in three waves of data collection. We applied a procedure for creating an index of inconsistent responding at each wave that involved identifying pairs of items with considerable redundancy and calculating discrepancies in responses to these items. Inconsistent responding was generally low in the Middle School sample and moderate in the College sample, with individuals showing only modest stability in inconsistent responding over time. Multiple regression analyses identified several baseline variables-including demographic, personality, and behavioral variables-that were uniquely associated with inconsistent responding both cross-sectionally and prospectively. Alcohol and substance involvement showed some bivariate associations with inconsistent responding, but these associations largely were accounted for by other factors. The results suggest that high levels of carelessness or inconsistency do not appear to characterize participants' responses to longitudinal web-based surveys of substance use and support the use of inconsistency indices as a tool for identifying potentially problematic responders.

Intergenerational transfer of smoking across three generations and forty-five years

OBJECTIVES

Although many have examined the linkages between smoking behaviors across 2 generations, few have examined these linkages among 3 generations.

METHODS

U.S. population representative data for 3 generations are drawn from the Panel Study of Income Dynamics (PSID) in order to examine whether smoking behaviors are passed down from generation to generation and the magnitude of the influence of smoking behaviors across generations (N = 830).

RESULTS

Results indicate direct linkages between both grandparent (G1) and parent (G2) smoking (OR = 4.53; 95% CI = 2.57-7.97) and parent (G2) and young adult offspring (G3) smoking (OR = 2.91; 95% CI = 1.60-5.31). Although the direct link between grandparent (G1) and grandchildren (G3) was not significant (OR = 2.25; 95% CI = 0.96-5.23, p < .10), mediation analyses reveal that the link between G3 and G1 smoking is significantly mediated by G2 smoking.

CONCLUSIONS

Regardless of generation, parent smoking behavior has a direct influence on offspring smoking behavior. The link between grandparent (G1) and grandchild (G3) smoking is mediated by parent (G2) smoking, suggesting that smoking behavior is passed from one generation to the next generation and in turn to the next generation.

Family smoking history moderates the effect of expectancies on smoking initiation in college students

AIMS

This report was designed to test the hypothesis that family history of smoking (FH) would moderate the effects of positive and negative smoking expectancies on initiation in a college sample.

DESIGN

Secondary analysis of a study of college freshmen never-smokers (n=196; 46% male) who completed a baseline interview and quarterly online follow-up assessments for 15 months.

FINDINGS

Analyses indicated that FH moderated the effect of negative outcome expectancies (p=.003) but not the effects of expectancies for positive or negative reinforcement on the probability of smoking initiation. Stronger negative expectancies were associated with a decreased risk of initiation for family history positive but not family history negative participants.

CONCLUSIONS

Findings are consistent with previous tobacco research indicating that FH+adolescents have more negative expectancies about cigarette smoking. This suggests that adolescents observing negative consequences or receiving negative messages from their parents about cigarettes may be less likely to experiment with smoking.

The intergenerational transmission of smoking in adulthood: a 25-year study of maternal and offspring maladaptive attributes

While smoking is a major cause of mortality and morbidity, and maternal smoking is a risk factor for smoking among their offspring, the mechanisms involved in the intergenerational transmission of smoking are not well understood. This study examines the pathways from maternal and adolescent child factors, and the parent-child relationship, to smoking among the adult offspring, approximately 25 years later. Data for the present analysis were based on time waves 2 (T2; 1983) and 7 (T7; 2007-2009) of an on-going study of a community sample of mothers and their children. Offspring and mother X¯ ages were 14.1 and 40.0 years, respectively, at T2, and 36.6 and 65.0 years, respectively, at T7. At T2, trained interviewers administered individual structured interviews. Psychosocial questionnaires were self-administered at T7. Structural equation modeling (SEM) was used to analyze the interrelationships among maternal and offspring attributes (T2 and T7). SEM results indicated a satisfactory model fit (RMSEA=0.052; CFI=0.91; SRMR=0.057), and confirmed hypothesized pathways. One pathway linked maternal maladaptive attributes (T2) to the mother-adolescent child attachment relationship (T2), which was associated with the offspring's maladaptive attributes over time (T2 to T7), which then predicted the adult offspring's smoking (T7). Other pathways highlighted the stability of maternal smoking, the continuity of maladaptive attributes, and less offspring educational attainment as predictors of offspring smoking at T7. Findings suggest the importance of early interventions to treat maternal smoking, maternal and offspring maladaptive attributes, and the mother-child relationship in order to reduce risk factors for the intergenerational transmission of smoking behavior. Interventions which enhance educational success should also prove effective in reducing smoking.

Short-term effects of a home-based smoking prevention program on antismoking socialization and smoking-related cognitions: a cluster randomized controlled trial

OBJECTIVE

This study aims to evaluate the short-term effects of a home-based smoking prevention program called 'Smoke-free Kids' on antismoking socialization and smoking-related cognitions and the moderating role of parental smoking.

PARTICIPANTS AND METHODS

A cluster randomized controlled trial was carried out using one intervention condition compared with a control condition. A total of 1,398 never-smoking children (mean age 10.11 years, SD 0.78) participated. Intention-to-treat and completers-only analyses were performed. Participants in the intervention condition (n=728) received 5 activity modules by mail at 4-week intervals. Modules included communication sheets for their mothers. Participants in the control condition (n=750) received a fact-based intervention only. The main outcomes were the frequency and quality of communication, nonsmoking agreement, house rules, availability of cigarettes, perceived maternal influence, anticipated maternal reactions, attitude, self-efficacy and social norms.

RESULTS

Significant effects of the program were found for frequency of communication (B=0.11, p<0.001), nonsmoking agreement (B=0.07, p<0.01), perceived maternal influences (B=0.09, p<0.05), self-efficacy (B=-0.09, p<0.05) and social norms of friends (B=-0.08, p=0.05) and best friends (B=-0.11, p<0.05). Parental smoking had no moderating effect.

CONCLUSIONS

The Smoke-free Kids program shows promising short-term effects on antismoking socialization and cognitions. Long-term follow-up on the effects of smoking behavior are needed.

Attention deficit/hyperactivity disorder symptoms and depression symptoms as mediators in the intergenerational transmission of smoking

BACKGROUND

Attention deficit/hyperactivity disorder and depression have been found to be comorbid with smoking behaviors, and all three behavioral syndromes have been shown to be familially transmitted. The present paper reports on the results of analyses testing whether child attention deficit/hyperactivity disorder and depression symptoms were mediators in the intergenerational transmission of cigarette smoking.

METHOD

Path analyses using bootstrapped mediation procedures were conducted on data from a community sample of 764 families (one or both parents and one adolescent offspring) from the Indiana University Smoking Survey. Parents reported on their smoking behaviors, ADHD, and depression and their child's ADHD, while offspring reported on their smoking behaviors and depression.

RESULTS

Although fathers' and mothers' smoking status, depression, and ADHD were not significantly correlated with boys' smoking initiation, there was a significant mediated (indirect) pathway from mothers' depression to boys' smoking initiation through boys' depression. Several parental variables were significantly correlated with smoking initiation in girls, and the pathways from mothers' smoking status, mothers' ADHD, and fathers' smoking status to girls' smoking initiation were significantly mediated by girls' ADHD.

CONCLUSIONS

For adolescent girls, the intergenerational transmission of ADHD appears to be important in understanding the intergenerational transmission of cigarette smoking. Sex differences in the intergenerational transmission of psychopathology as it leads to smoking initiation were also discussed.

Smoking-specific communication and children's smoking onset: an extension of the theory of planned behaviour

The aim of this study was to test whether maternal smoking-specific communication and parental smoking related to smoking cognitions (i.e. attitude, self-efficacy and social norm) derived from the Theory of Planned Behaviour in association with smoking onset during preadolescence. A total of 1478 pairs of mothers and children participated (mean age: 10.11; standard deviation = 0.78). Structural equation models in Mplus were used to examine whether smoking-specific communication influences children's smoking cognitions, which in turn, affect smoking onset. A positive association was found between pro-smoking attitudes and smoking onset. Smoking-specific communication and parental smoking were related to smoking cognitions. Specifically, frequency of communication was negatively associated with pro-smoking attitudes, social norms of mother and best friend. Quality of communication related negatively to pro-smoking attitudes and positively to self-efficacy and norms of friends. Parental smoking was positively associated with pro-smoking attitudes and norms of mother and (best) friends. Additionally, more frequent communication and higher levels of parental smoking were associated with higher smoking onset. In conclusion, smoking-specific communication and parental smoking were associated with smoking cognitions and smoking onset. Already during preadolescence, parents contribute to shaping the smoking cognitions of their children, which may be predictive of smoking later in life.

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.

Family history and oral health: findings from the Dunedin Study

CONTEXT

The effects of the oral health status of one generation on that of the next within families are unclear.

OBJECTIVES

  To determine whether parental oral health history is a risk factor for oral disease.

METHODS

Oral examination and interview data were collected during the age-32 assessments in the Dunedin Study. Parental data were also collected on this occasion. The sample was divided into two familial-risk groups for caries/tooth loss (high risk and low risk) based on parents' self-reported history of tooth loss at the age-32 assessment interview.

MAIN OUTCOME MEASURES

Probands' dental caries and tooth loss status at age 32, together with lifelong dental caries trajectory (age 5-32).

RESULTS

Caries/tooth loss risk analysis was conducted for 640 proband-parent groups. Reference groups were the low-familial-risk groups. After controlling for confounding factors (sex, episodic use of dental services, socio-economic status and plaque trajectory), the prevalence ratio (PR) for having lost 1+ teeth by age 32 for the high-familial-risk group was 1.41 [95% confidence interval (CI) 1.05, 1.88] and the rate ratio for DMFS at age 32 was 1.41 (95% CI 1.24, 1.60). In the high-familial-risk group, the PR of following a high caries trajectory was 2.05 (95% CI 1.37, 3.06). Associations were strongest when information was available about both parents' oral health. Nonetheless, when information was available for one parent only, associations were significant for some outcomes.

CONCLUSIONS

People with poor oral health tend to have parents with poor oral health. Family/parental history of oral health is a valid representation of the intricacies of the shared genetic and environmental factors that contribute to an individual's oral health status. Associations are strongest when data from both parents can be obtained.

Interaction between parenting and neighborhood quality on the risk of adolescent regular smoking

PURPOSE

To conduct the first study to examine potential interaction between parenting style and neighborhood quality on the risk of adolescent regular smoking.

METHODS

We analyzed data from a nationally representative sample of U.S. adolescents (n = 1,213 pairs of adolescents and their parents) who participated in the Panel Study of Income Dynamics during 2002-2003. Regular smoking behavior and parental monitoring level were reported by adolescents. Parenting style (i.e., authoritative, authoritarian, permissive, and uninvolved) was defined by cross-classifying self-reported parental warmth and control. Based on parents' perceived neighborhood quality regarding raising children, neighborhoods were identified as either higher quality or lower quality.

RESULTS

Adolescents in lower-quality neighborhoods were more likely to be regular smokers (13.7% vs. 8.5%; adjusted odds ratio [AOR] = 1.93, 95% CI = 1.02-3.65) than those in higher-quality neighborhoods. In lower-quality neighborhoods, adolescents of authoritarian parents (16.9%; AOR = 10.97, 95% CI = 3.36-35.84) were more likely and those of uninvolved parents (20.3%; AOR = 3.47, 95% CI = 0.91-13.17) were marginally more likely to be regular smokers than those of authoritative parents (4.3%). However, among adolescents in higher-quality neighborhoods, parenting style was independent of the risk of regular smoking. There was marginally significant interaction between authoritarian parenting style and neighborhood quality. Parental monitoring was associated with reduced risk of adolescent smoking, regardless of neighborhood quality. There was no interaction between parental monitoring and neighborhood quality.

CONCLUSIONS

Authoritative parenting is associated with reduced risk of adolescent regular smoking in lower-quality neighborhoods but not in higher-quality neighborhoods. Authoritative parenting style and parental monitoring may buffer adverse influences of low-quality neighborhood.

Strategies for characterizing complex phenotypes and environments: general and specific family environmental predictors of young adult tobacco dependence, alcohol use disorder, and co-occurring problems

BACKGROUND

Defining phenotypes in studies of tobacco and alcohol misuse is difficult because of the complexity of these behaviors and their strong association with each other and with other problem behaviors. The present paper suggests a strategy for addressing this issue by conceptualizing and partitioning variance in phenotypes into either general or substance/behavior-specific. The paper also applies the general or substance/behavior-specific conceptualization to environmental predictors of tobacco and alcohol misuse and other problem behaviors.

METHODS

Data were drawn from the Seattle Social Development Project, a contemporary, ethnically diverse and gender-balanced longitudinal panel including 808 participants. Latent variable modeling was used to partition variance in young adult (age 24) nicotine dependence, alcohol abuse and dependence, illicit drug abuse and dependence, involvement in crime, and engagement in HIV sexual risk behavior into general problem behavior and behavior-specific variance. Similarly, measures of general, drinking-specific, and smoking-specific adolescent family environment were constructed.

RESULTS

Consistent with expectations, more positive general family environment during adolescence was associated with lower levels of shared variance in problem behaviors at age 24, but not with unique variance in tobacco or alcohol use disorder. Higher levels of family smoking and drinking environments during adolescence, however, were positively associated with unique variance in tobacco and alcohol use disorder, respectively, but did not predict shared variance in problem behaviors.

CONCLUSIONS

Results support the utility of the proposed approach. Ways in which this approach might contribute to future molecular genetic studies are discussed.

Risk and protective factors for nicotine dependence in adolescence

BACKGROUND

We investigated the role of psychosocial and proximal contextual factors on nicotine dependence in adolescence.

METHODS

Data on a multiethnic cohort of 6th to 10th graders from the Chicago public schools were obtained from four household interviews conducted with adolescents over two years and one interview with mothers. Structural equation models were estimated on 660 youths who had smoked cigarettes by the first interview.

RESULTS

Pleasant initial sensitivity to tobacco use, parental nicotine dependence (ND), adolescent ND and extensiveness of smoking at the initial interview had the strongest total effects on adolescent ND two years later. Perceived peer smoking and adolescent conduct problems were of lesser importance. Parental ND directly impacted adolescent ND two years later and had indirect effects through pleasant initial sensitivity and initial extensiveness of smoking. Parental depression affected initial adolescent dependence and depression but adolescent depression had no effect on ND. The model had greater explanatory power for males than females due partly to the stronger effect of conduct problems on dependence for males than females.

CONCLUSIONS

The findings underscore the importance of the initial drug experience and familial factors on adolescent nicotine dependence and highlight the factors to be the focus of efforts targeted toward preventing ND among adolescents.