Parental influences predict adolescent smoking in the United States, 1989–1993

doi:10.1016/S1054-139X(98)00013-5

Journal of Adolescent Health

Volume 22, Issue 6, June 1998, Pages 466-474

https://doi.org/10.1016/S1054-139X(98)00013-5 Get rights and content

Abstract

Purpose: To examine parental influences on two transitions in the adolescent smoking uptake process: from never having smoked to experimentation and from experimentation to established smoking.

Methods: Using data from the longitudinal Teenage Attitudes and Practices Survey of 1989–1993, we related perceived parental concern about their adolescents’ future smoking, parental smoking status, problem-solving communication between parent and adolescent, demographics, and other factors at baseline to experimentation by follow-up among those who had never puffed on a cigarette (n = 4149). We also related these factors at baseline to reaching a lifetime level of smoking of at least 100 cigarettes by follow up among those who had experimented but smoked <100 cigarettes (n = 2684) in univariate and multivariate analyses.

Results: Among never-smokers, baseline susceptibility to smoking and having male best friends who smoke predicted experimentation in the next 4 years. Among experimenters, susceptibility to smoking, having male or female best friends who smoked, and lack of parental concern about future smoking distinguished those who progressed to established smoking by follow-up. Furthermore, communicating with parents first about serious problems was protective against progression from experimentation to established smoking.

Conclusion: Interventions aimed at reducing adolescent smoking should encourage cessation for parents who smoke and help parents communicate strong antismoking norms to children and adolescents and maintain strong lines of communication with them.

Section snippets

Survey sample

The Teenage Attitudes and Practices Survey (TAPS) was designed to provide information on adolescent smoking behavior and was developed under the direction of the National Center for Health Statistics and the Office on Smoking and Health, Centers for Disease Control and Prevention 33. The TAPS interviewed adolescents identified from the 1989 National Health Interview Survey (NHIS), an annual household interview survey of the civilian, noninstitutionalized population of the United States. The

Univariate analyses of the influences of parents and best friends predicting progression

A strong univariate association was observed between each parent and best friend influence question and a later smoking behavior (Table 1). Adolescent experimenters who reported first talking to someone other than a parent about serious problems were more likely to have made a transition to established smoking by follow-up. Of those who progressed from never smoking in 1989 to experimentation in 1993 (n = 4149), approximately 36–43% who were exposed to smoking by parents or best friends in 1989

Discussion

This article reports the natural history of smoking behavior in a large national sample of adolescents who either reported in 1989 that (a) they had never so much as puffed on a cigarette, or (b) they had at least puffed on a cigarette but had not smoked at least 100 cigarettes in their lifetime. By the follow-up survey 4 years later, approximately 35% of the never-smoking sample reported progression from never smoking to experimentation with cigarettes, and nearly 31% of the experimenters had

Acknowledgements

Preparation of this article was supported by funding from the Robert Wood Johnson Foundation and Cancer Prevention Research Unit NIH Grant no. CA72092. This work was done during the tenure of Dr. Pierce’s established investigatorship from the American Heart Association.

References (43)

K.E Bauman et al.
Antecedents, subjective expected utility and behaviorA panel study of adolescent cigarette smoking
Addict Behav
(1984)
I Ajzen et al.
The prediction of behavior from attitudinal and normative variables
J Exp Soc Psychol
(1970)
H.D Chilcoat et al.
Impact of parent monitoring on initiation of drug use through late childhood
J Am Acad Child Adolesc Psychiatry
(1996)
P Farrell et al.
Schooling and healthThe cigarette connection
J Health Econ
(1982)
The Health Consequences of Smoking25 Years of Progress. A Report of the Surgeon General. DHHS Pub. no. (CDC)89-8411
(1989)
Preventing Tobacco Use Among Young PeopleA Report of the Surgeon General
(1994)
E.A Gilpin et al.
Smoking initiation rates in adults and minors. United States 1944–1988
Am J Epidemiol
(1994)
Cigarette smoking among youth—United States, 1989
MMWR
(1991)
L Lee et al.
Changes in the patterns of initiation of cigarette smoking in the United States1950, 1965, and 1980
Cancer Epidemiol Biomarkers Prevent
(1993)
Johnston LD, O’Malley PM, Bachman JG. National Survey Results on Drug Use from Monitoring the Future Study, 1975–1992,...

D.E Nelson et al.

Trends in cigarette smoking among US adolescents, 1974 through 1991

Am J Public Health

(1995)

B.R Flay et al.

Cigarette smokingWhy young people do it and ways of preventing it

K.M Conrad et al.

Why children start smokingPredictors of onset

Br J Establish Smoking

(1992)

A.D McNeill et al.

Prospective study of factors predicting uptake of smoking in adolescents

J Epidemiol Commun Health

(1988)

S Sussman et al.

Psychosocial predictors of cigarette smoking onset by whites, black, Hispanic, and Asian adolescents in Southern California

MMWR

(1987)

B.R Flay et al.

Differential influence of parental and friends’ smoking on adolescent initiation and escalation of smoking

J Soc Health Behav

(1994)

L Chassin et al.

The natural history of cigarette smoking from adolescence to adulthoodDemographic predictors of continuity and change

Health Psychol

(1996)

L.M Collins et al.

Psychosocial predictors of young adolescent cigarette smokingA sixteen-month, three-wave longitudinal study

J Appl Soc Psychol

(1987)

W.F Skinner et al.

Social influences and constraints on the initiation and cessation of adolescent tobacco use

J Behav Med

(1985)

G.J Botvin et al.

Adolescent tobacco, alcohol, and drug abusePrevention strategies, empirical findings, and assessment issues

Develop Behav Pediatrics

(1992)

A Biglan et al.

Peer and parental influences on adolescent tobacco use

Behav Med

(1995)

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did not find a moderating effect. Only de Leeuw et al. (2013) measured positive problem solving and two studies (den Exter Blokland et al., 2006; Distefan et al., 1998) measured withdrawal. No studies found a direct or moderating effect of parental smoking on smoking onset.
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.
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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.
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Original ArticlesParental influences predict adolescent smoking in the United States, 1989–1993

Abstract

Section snippets

Survey sample

Univariate analyses of the influences of parents and best friends predicting progression

Discussion

Acknowledgements

Addict Behav

J Exp Soc Psychol

J Am Acad Child Adolesc Psychiatry

J Health Econ

The Health Consequences of Smoking25 Years of Progress. A Report of the Surgeon General. DHHS Pub. no. (CDC)89-8411

Preventing Tobacco Use Among Young PeopleA Report of the Surgeon General

Smoking initiation rates in adults and minors. United States 1944–1988

Am J Epidemiol

Cigarette smoking among youth—United States, 1989

MMWR

Changes in the patterns of initiation of cigarette smoking in the United States1950, 1965, and 1980

Cancer Epidemiol Biomarkers Prevent

Trends in cigarette smoking among US adolescents, 1974 through 1991

Am J Public Health

Cigarette smokingWhy young people do it and ways of preventing it

Why children start smokingPredictors of onset

Br J Establish Smoking

Prospective study of factors predicting uptake of smoking in adolescents

J Epidemiol Commun Health

Psychosocial predictors of cigarette smoking onset by whites, black, Hispanic, and Asian adolescents in Southern California

MMWR

Differential influence of parental and friends’ smoking on adolescent initiation and escalation of smoking

J Soc Health Behav

The natural history of cigarette smoking from adolescence to adulthoodDemographic predictors of continuity and change

Health Psychol

Psychosocial predictors of young adolescent cigarette smokingA sixteen-month, three-wave longitudinal study

J Appl Soc Psychol

Social influences and constraints on the initiation and cessation of adolescent tobacco use

J Behav Med

Adolescent tobacco, alcohol, and drug abusePrevention strategies, empirical findings, and assessment issues

Develop Behav Pediatrics

Peer and parental influences on adolescent tobacco use

Behav Med

Original Articles
Parental influences predict adolescent smoking in the United States, 1989–1993