Evolution of the association between parental and child smoking in Finland between 1977 and 2005

Intergenerational transmission of parental risky health behaviors in Chinese children: Are there socioeconomic status differences?

Background

Risky health behaviors in childhood, including smoking, alcohol consumption, and having a poor diet, are the major sources of non-communicable diseases in adulthood. This study aimed to examine how parents affect children's risky health behaviors and whether intergenerational transmission differs based on socioeconomic status (SES).

Methods

Data were extracted from the 1991-2015 China Health and Nutrition Survey (CHNS). Smoking (n = 5,946), alcohol consumption (n = 7,821), and sugar-sweetened beverages (SSBs) consumption (n = 3,537) were used as proxies for risky health behaviors in children. A binary choice model for panel data with a random-effect specification was employed to examine whether risky health behaviors can be transmitted from parents to their children. Subsequently, we conducted a seemingly unrelated estimation test (SUEST) to explore the differences in parental transmission between the different SES groups.

Results

We found strong intergenerational persistence of smoking, alcohol drinking, and SSBs drinking behaviors, except for the mothers' smoking behavior. Mothers had a greater influence on children's alcohol drinking and SSBs drinking behaviors than fathers both in urban and rural areas and in different SES groups. The intergenerational transmission of SSBs drinking behavior exhibited a decreasing trend with increasing SES for both urban and rural families. In urban areas, mothers' alcohol drinking behavior has a decreasing trend with increasing education level, occupation, and income; however, in rural areas, the influence of mothers' alcohol drinking behavior occurred in the same direction with increasing education level and occupation type. In rural areas, the influence of fathers' drinking and smoking behaviors on children appears to mostly increase with increasing SES. Meanwhile, the influence of such behaviors among urban fathers would decrease with increasing SES.

Conclusion

Parents' behaviors and SES can influence the initiation of risky health behaviors in their offspring. Thus, to promote healthy behaviors, policymakers can introduce health education programs for parents, particularly for those living in rural areas and with a low SES.

Intergenerational social mobility, smoking and smokeless tobacco (snus) use among adolescents during 2008-2017

BACKGROUND

Socioeconomic differences in smoking and other tobacco use are prevalent in adolescents. Less is known about the association between intergenerational social mobility and tobacco use.

METHODS

Five waves of national cross-sectional School Health Promotion Study during 2008-2017 in Finland were used, including non-academically and academically oriented adolescents (15-21 years, N = 384,379). The adolescents' educational orientation was compared with the educational track of the parents as a proxy for intergenerational social mobility, which was used as the independent variable in regression models to examine the differences in daily smoking and daily snus use.

RESULTS

Smoking declined in all mobility groups over time, but remained more prevalent among non-academically oriented adolescents among boys and girls. Daily snus use among boys increased over time in all mobility groups. Multiple adjusted models showed that upward mobility and downward mobility are differently associated with tobacco use, the latter increasing the probability of tobacco use compared with the stable high group (boys: smoking: OR = 5.24, 95% CI 5.02-5.46; snus use: OR = 1.57, 95% CI 1.50-1.66). In smoking, absolute socioeconomic differences between the mobility groups decreased over time while relative differences increased. In snus use, both absolute and relative differences increased.

CONCLUSIONS

Adolescent smoking and snus use associate strongly with the adolescent's educational track, irrespective of the social mobility class. Non-academically oriented adolescents have an increased risk of tobacco use. The academic and non-academic orientation should already be taken into account in tobacco use prevention in basic education.

Transmission of Smoking across Three Generations in Finland

The influence of parents’ smoking on children’s smoking is well known, but few studies have examined the association between grandparents’ and grandchildren’s smoking. We studied the association between paternal and maternal grandparents’ smoking and their grandchildren’s tobacco use and assessed whether parents’ smoking is a mediator in this process. Data were obtained from a national survey of 12–18-year-old Finns in 2013 (N = 3535, response rate 38%). Logistic regression and mediation analyses were used. Both boys and girls had higher odds for smoking experimentation, daily smoking and other tobacco or tobacco-like product use if their mother, father or any of the four grandparents were current or former smokers. When parents’ and grandparents’ smoking status were included in the same model, grandparents’ smoking generally lost statistical significance. In the mediation analysis, 73% of the total effect of grandparents’ smoking on grandchildren’s daily smoking was mediated through parents’ smoking, 64% on smoking experimentation and 63% on other tobacco or tobacco-like product use. The indirect effect of a mother’s smoking was higher than that of a father’s. To conclude, paternal and maternal grandparents’ smoking increases grandchildren’s tobacco use. The influence is mainly, but not completely, mediated through parents’ smoking.

Tobacco use and exposure to tobacco promoting and restraining factors among adolescents in a developing country

OBJECTIVE

With a long history of tobacco cultivation, adolescents in Ghana are at relatively high risk of the emerging tobacco epidemic in developing countries. This study explored exposure to tobacco promoting/restraining factors and their associations with smoking and tawa (traditional smokeless tobacco) use among 13-18-year-old Ghanaians.

METHODS

School-based representative data were collected in 2008 (n = 1165).

RESULTS

Prevalence rates of tobacco use, smoking and tawa use were 9.1% (11.5% boys and 6.4% girls), 6.6% (8.0% boys and 4.7% girls) and 5.7% (7.3% boys and 3.9% girls), respectively. Four percent of the respondents attended schools without a smoking ban, 66% had been taught about the harmful effects of smoking in the current school year, and 53% had been exposed to tobacco advertising. Fifty-three percent of adolescents who had tried to purchase tobacco products were not refused because of their age. Multivariate analyses found that attendance at a school where smoking was allowed, not having been taught about the harmful effects of smoking, exposure to tobacco advertising and parental smoking were positively associated with tobacco use, and knowledge that smoking is harmful to health and difficult to quit were negatively associated with tobacco use.

CONCLUSIONS

Both smoking and tawa use were relatively low among Ghanaian adolescents. Exposure to tobacco advertising was high. There is no tobacco legislation in Ghana, but societal norms or cultural values seem to restrict smoking in schools and access to tobacco products.

What limits the effectiveness of school-based anti-smoking programmes?

BACKGROUND

It is generally accepted that living in families where there are smokers, children are stressed not only by the harmful physical exposure to second-hand and third-hand tobacco smoke, but also by the negative models of the adult relatives' behaviour, as relatives who smoke can inspire children to imitate this behaviour, influencing attitudes towards, and early experiments with smoking. In this paper, some of the most important results about influence of family smoking on the effects of the anti-smoking educational programme "Non-smoking Is Normal" are described.

METHODS

The school-based programme was created by medical and educational specialists and targets children at the first level of primary schools (aged from 6 to 11 years). The data about interesting outcomes of the programme (knowledge, attitudes, behaviour) were collected by anonymous questionnaire, administered twice in each school year: one month before the complex of 5 lectures (pre-tests) and 4-5 months after the last lecture (post-tests). The sample of participants (860-910) was divided into four groups, according to the intervention and family backrounds: (1) programme children from smoking families "P-S"; (2) control children from smoking families "C-S"; (3) programme children from non-smoking families "P-NS"; (4) control children from non-smoking families "C-NS". The differences in the frequency of children's answers were analysed using the tests in statistic Epi Info software, version 6.04a (chi-square, Mantel Haenszel, Yates, Fisher).

RESULTS

In the programme group, the number of children with smoking relatives was significantly higher than in the control group (80.1% vs. 73.0%, p < 0.01) as well as of those who reported frequent/daily exposure to secondhand smoke at homes and/or in cars (49.5% vs. 40.0%, p < 0.01). Smoking families significantly influenced the children's seeking of smoking friends (40% vs. 17%, p < 0.01). The programme has significantly increased the amount of knowledge about health risks of smoking. Both in the programme and control groups of children from non-smoking families, the frequency of critics of adults smoking was significantly higher all the time of the study (p < 0.05 and 0.01 resp.); however, the programme influenced children's opinions about smoking (criticism) only partially. Children's actual intentions about their smoking in the future was fully influenced by their smoking household environment: the number of "future no-smokers" has decreased in time and was significantly less frequent among children from smoking families (p < 0.01). The frequency of those willing to smoke significantly increased within the period between 3rd and 5th grades, both in the programme and the control groups (p < 0.01). An almost linear increase of active experimentations with cigarette smoking in follow-up monitoring was seen, trends of smoking children were steeper in groups from smoking families. The number of experiments with smoking was significantly lower in programme children of non-smoking parents only at the end of the study (p < 0.05).

CONCLUSIONS

Despite of the effort to initiate parental participation on the primary prevention of smoking, we have confirmed that smoking in families decreased the efficacy of anti-smoking intervention targeted on young children at school age.

Dietary and oral hygiene intervention in secondary school pupils

BACKGROUND

To enhance the well-being of secondary school pupils by improving their eating habits, especially school-based eating, a joint project, including oral health intervention, was conducted during the academic year 2007-2008.

AIM

The aim was to study the effect of a dietary intervention on schoolchildren's eating habits and laser fluorescence (LF) values of teeth.

METHODS

Twelve schools in three cities, Finland, were randomly assigned to be intervention and control schools. Two of the intervention schools were further assigned in the instruction of oral hygiene. In 2007 and 2008, the pupils (n=739 and 647, respectively) answered a questionnaire on dietary and oral health habits, and LF values on the occlusal surfaces of molars and premolars were determined.

RESULTS

The frequency of eating a warm meal and drinking water at school to quench thirst increased in the intervention schools but decreased in the control schools (P<0.001 and P=0.005, respectively). LF values in molars decreased in schools with dietary intervention only (P=0.024).

CONCLUSIONS

  The 1-year dietary intervention was long enough to show improvement in eating habits and in habits for quenching thirst, and some decrease in the LF values of molars.

Smoking offsets the metabolic benefits of parental longevity in women: the CoLaus study

OBJECTIVE

We evaluated whether subjects with long-lived parents show lower levels of cardiovascular risk factors, including the metabolic syndrome.

METHODS

We analyzed data from a Swiss population-based sample (1163 men and 1398 women) aged 55-75 years from Lausanne. Participants were stratified by number of parents (0, 1, 2) who survived to 85 years or more. The associations of parental longevity with cardiovascular risk factors and related metabolic variables were analyzed using multiple linear regressions.

RESULTS

Age-adjusted metabolic syndrome prevalence varied from 24.8%, 20.5% to 13.8% in women (P<0.05) and from 28.8%, 32.1% to 27.6% in men (not significant) with 0, 1 and 2 long-lived parents. The association between parental longevity and metabolic syndrome prevalence was particularly strong in women who had never smoked. In this group, women with 2 long-lived parents had lower Body Mass Index and smaller waist circumference. In never-smokers of both genders, mean (95% CI) adjusted High Density Lipoprotein-cholesterol levels were 1.64(1.61-1.67), 1.67(1.65-1.70) and 1.71(1.65-1.76) mmol/L for 0, 1 and 2 long-lived parents (P<0.01), respectively. The trend was not significant in former and current smokers.

CONCLUSIONS

In women, not in men, parental longevity is associated with a better metabolic profile. The metabolic benefits of having long-lived parents are offset by smoking.