Illusions of Parental Control: Parenting and Smoking Onset in Dutch and Swedish Adolescents1

Family Support as Smoking Prevention during Transition from Early to Late Adolescence: A Study in 42 Countries

Family support has a beneficial impact on protecting health-risk behaviour in adolescents. This study aimed to explore whether family support is associated with risk of smoking during transition from early (11 years) to late (15 years) adolescence across 42 countries. The data from the cross-national Health Behaviour in School-aged Children (HBSC) study in 2017/2018 were employed (N = 195,966). Family support was measured using the four-item Family dimension of the Multidimensional Scale of Perceived Social Support (sum score 20 or more was categorised as high family support). Smoking was defined as a reported cigarette smoking at least 1-2 days in the last 30 days. The association between smoking and family support was assessed using a prevalence ratio (PR) obtained from the multivariate Poisson regression. Over two thirds of adolescents reported high levels of support from their family. Family support was found to significantly decrease with age in most of the countries, with the boys reported high level of family support more often than girls. The adolescents who reported having low family support also were more likely to smoke compared to their peers who reported having high family support (PR = 1.81; 95% CI: 1.71-1.91 in boys, and PR = 2.19; 95% CI: 2.08-2.31 in girls). The countries with a stronger effect of family support in reducing smoking risk indicated lower rates of adolescent smoking as well as lower increases in the cigarette smoking prevalence during the age period from 11 to 15 years. This study reinforces the need for family support, which is an important asset helping adolescents to overcome the risk of smoking during their transition from early to late adolescence.

Parental Anti-Smoking Encouragement as a Longitudinal Predictor of Young Adult Cigarette and E-cigarette Use in a US National Study

INTRODUCTION

Young adulthood is a critical period for the adoption of risk behaviors like tobacco use. Protective factors in adolescence may promote a tobacco-free transition to young adulthood. We examine associations between the frequency of parental anti-smoking encouragement in adolescence and cigarette and e-cigarette use in young adulthood.

AIMS AND METHODS

We analyzed data from Waves 1 (2009-2010, 10th grade, mean age = 16.2 years) and 5 (2013-2014 mean age = 20.3 years) of the US nationally representative NEXT Generation Health Study (n = 1718). At Wave 1, participants reported how often their parents or guardians encourage them to not smoke cigarettes (1 = Rarely or Never, 7 = Frequently). We used separate weighted multiple logistic regression models to model Wave 5 past 30-day cigarette and e-cigarette use as functions of the frequency of parental anti-smoking encouragement at Wave 1, adjusting for sociodemographic and parenting factors, initial substance use, and peer tobacco use.

RESULTS

The average frequency of parental encouragement to not smoke cigarettes was fairly high (mean = 5.35). At Wave 5, 24.7% and 14.2% of respondents reported cigarette and e-cigarette use in the past 30 days, respectively. Greater frequency of parental anti-smoking encouragement was associated with lower odds of subsequent cigarette smoking (adjusted odds ratio 0.91, 95% confidence interval 0.83, 0.99) but its association with e-cigarette use was not significant (adjusted odds ratio 0.93, 95% confidence interval 0.84, 1.04).

CONCLUSIONS

The longitudinal negative association between anti-smoking encouragement and cigarette use suggests that parental anti-tobacco communication could be a long-term protective factor against young adult tobacco use. Our findings may also suggest the importance of product-specific messages in the evolving tobacco use landscape.

IMPLICATIONS

This study builds upon prior investigations of parenting in adolescence as a protective factor against young adult risk behavior. We isolate the frequency of anti-smoking encouragement during adolescence as an actionable factor distinct from other parenting variables. Our findings also suggest that message specificity may be an important factor in parental anti-tobacco communication as youth and young adult tobacco use becomes increasingly dominated by e-cigarettes.

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.

The Effects of Antismoking Messages From Family, School, and Mass Media on Smoking Behavior and Smoking Intention Among Chinese Adolescents

The prevalence of adolescent smoking has been increasing rapidly in China. Expanding adolescent exposure to antismoking messages may be an effective approach to prevent tobacco use among this population. Using a cross-sectional sample of 8,444 high school students in four Chinese cities, this study assessed the relation between self-reported exposure to antismoking messages from families, schools, and mass media and the rate of past 30-day smoking and smoking intention among junior and senior high school students. Results from logistic regression suggested that antismoking messages delivered via school and media inhibited both tobacco use and the intention to smoke. The effects of familial warnings about harmful effects of smoking, in contrast, were at best insignificant.

Parenting practices and adolescent smoking in mainland China: the mediating effect of smoking-related cognitions

This study examined the direct and indirect associations of general and smoking-specific parenting practices with Chinese adolescents' smoking behaviors. Adolescents aged 14-17 years (N = 658) and their parents were recruited from three high schools in mainland China. Adolescents completed an anonymous online survey on their smoking behaviors, perceptions of parenting behaviors, and smoking-related cognitions including attitude, subjective norm, and perceived behavioral control. Parents completed a paper-and-pencil questionnaire on their parenting behaviors. Results indicated that psychological control and frequency of communication about smoking were positively linked to adolescent smoking through the mediation of two smoking-related cognitions-attitude and subjective norm. Parental knowledge of adolescent activities, disapproval of adolescent smoking, and home rules were negatively linked to adolescent smoking through the mediation of attitude and subjective norm. Results suggest that parenting practices and smoking-related cognitions are critical components to be incorporated in prevention and intervention programs for adolescent smoking in China.

Testing bidirectional effects between cannabis use and depressive symptoms: moderation by the serotonin transporter gene

Evidence for the assumption that cannabis use is associated with depression and depressive symptoms is inconsistent and mostly weak. It is likely that the mixed results are due to the fact that prior studies ignored the moderating effects of an individual's genetic vulnerability. The present study takes a first step in scrutinizing the relationship between cannabis use and depressive symptoms by taking a developmental molecular-genetic perspective. Specifically, we concentrated on changes in cannabis use and depressive symptoms over time in a simultaneous manner and differences herein for individuals with and without the short allele of the 5-hydroxytryptamine (serotonin) transporter gene-linked polymorphic region (5-HTTLPR) genotype. Data were from 310 adolescents over a period of 4 years. We used a parallel-process growth model, which allows co-development of cannabis use and depressive symptoms throughout adolescence, and the possible role of the 5-HTTLPR genotype in this process. We used data from the younger siblings of these adolescents in an attempt to replicate potential findings. The parallel-process growth model shows that cannabis use increases the risk for an increase in depressive symptoms over time but only in the presence of the short allele of the 5-HTTLPR genotype. This effect remained significant after controlling for covariates. We did not find conclusive support for the idea that depressive symptoms affect cannabis use. These findings were replicated in the sample of the younger siblings. The findings of the present study show first evidence that the links between cannabis use and depressive symptoms are conditional on the individual's genetic makeup.

The interplay between parental monitoring and the dopamine D4 receptor gene in adolescent cannabis use

BACKGROUND

Both environmental risk and genetic variation is believed to play a role in substance use. A candidate environmental variable is parenting. Recent studies have found support for the idea that the dopamine system affects the susceptibility to environmental influences. In the present study we will examine the interplay between effects of parental monitoring and the presence of the DRD4 7-repeat allele in adolescent lifetime cannabis use and the developmental course of cannabis use.

METHODS

A total of 311 adolescents participated in a five-wave longitudinal design. First, we conducted logistic regression analyses to examine the prospective associations between parental monitoring, the DRD4 polymorphism, their interaction and lifetime cannabis use. Second, individual growth parameters were calculated for frequency of cannabis use. Linear regression was used to assess the relationship between parental monitoring, the DRD4 polymorphism, their interaction, and the frequency of cannabis use.

RESULTS

There were no significant main effects of parental monitoring or the DRD4 polymorphism. However, both analyses showed that over a period of four years, a) when experiencing low levels of parental monitoring, individuals with the 7-repeat allele were more likely to show lifetime cannabis use and a stronger increase in frequency of cannabis use than individuals without this allele; b) when experiencing high levels of parental monitoring, individuals with the 7-repeat allele were less likely to show lifetime cannabis use and they showed a smaller increase in frequency of cannabis use than individuals without the 7-repeat allele.

CONCLUSIONS

This study shows that carriers of the DRD4 7-repeat allele are disproportionally affected by the negative and positive effects of parental monitoring such that carriers of the DRD4 7-repeat allele, as compared to non-carriers, are more likely to use cannabis when levels of parental monitoring are low, and less likely to use cannabis when parental monitoring levels are high.

Correlates of chilean adolescents' negative attitudes toward cigarettes: the role of gender, peer, parental, and environmental factors

INTRODUCTION

We examined the association of peer, parental, and environmental factors with negative attitudes toward cigarettes among youth from Santiago, Chile.

METHODS

A total of 860 youth from Santiago, Chile, completed questions regarding their lifetime use of cigarettes, intentions to smoke, attitudes toward cigarettes, and questions that assessed peer, parental, and environmental factors.

RESULTS

For both boys and girls, peer disapproval of smoking was associated with more negative attitudes toward cigarettes and peer smoking was associated with less negative attitudes toward cigarettes. Peer pressure was significantly associated with more negative attitudes toward cigarettes for girls only. Parental smoking was associated with less negative attitudes and parental control with more negative attitudes, but these associations were significant in the overall sample only. School prevention efforts and exposure to cigarette ads were not associated with cigarette attitudes. Difficulty in accessing cigarettes was positively associated with negative attitudes for boys and girls.

CONCLUSION

Smoking prevention efforts focus on attitude change, but scant information is available about the experiences that influence Chilean youth's attitudes toward cigarettes. Results from the current study suggest that prevention efforts could benefit from gender-specific strategies. Girls' but not boys' attitudes were influenced by peer pressure. Moreover, negative attitudes toward cigarettes were associated with lower current smoking in girls only. Parental smoking was an important influence on youth's attitudes toward cigarettes. Efforts to reduce smoking among Chilean youth may benefit from concurrently reducing parental smoking.

Predictors of smoking stage transitions for adolescent boys and girls

BACKGROUND

Aim of this study was to identify predictors of transition from never smoking to smoking monthly or more often in a European sample of adolescents. To show whether predictors differed between genders, analyses were run for boys and girls separately.

METHODS

From six European countries, 4055 never smokers participated at baseline (1998). One year later, respondents were asked to indicate their smoking status. Respondents were categorized as smoker (smoking monthly or more) or non-smoker (smoking less than monthly). The predictive qualities of predisposing, motivational and intentional concepts were assessed using logistic regression analyses.

RESULTS

Girls were more likely to be a smoker at follow-up. More spending money, modeling from parents and a higher intention to start smoking were predictive of smoking uptake in both genders. Boys were more likely to start smoking when perceiving less cons of smoking, drinking more alcohol and perceiving a social norm towards not smoking from parents. Girls experiencing higher social pressure to smoke from friends were more likely to start smoking.

CONCLUSIONS

Separate uptake prevention interventions for boys and girls do not seem warranted. Boys may benefit from a program also addressing other deviant behaviors. Girls should continue to be supplied with specific skills to resist social pressure.

Correspondence in collateral and self-reports on alcohol consumption: a within family analysis

The present study tests the degree to which parents and children correspond in their reports on each others quantity and frequency of alcohol consumption. Furthermore, the degree of inaccurate estimation by parents might be related to inappropriate parenting. Particularly, parents who have little control over and knowledge of their offspring's activities and whereabouts might underestimate adolescent alcohol consumption. A full family design was employed in which both parents and two adolescents were included. A total of 428 Dutch families participated and filled in questionnaires at home in the presence of a trained interviewer on frequency and quantity of drinking. Findings showed that parents as well as children underestimate alcohol consumption of each other, in particular concerning the quantity of drinking. It appears that parents are better able to accurately estimate when their child is not drinking than when their child is drinking. Children on the other hand are better able to predict frequency and quantity of parental drinking, but not parental heavy drinking. Finally, parental underestimations of adolescent drinking are indeed related to lack of parental knowledge and control. However, this was primarily found among mothers. In conclusion, survey studies using collateral reports on parental and adolescent drinking should acknowledge the fact that in most cases family members underestimate alcohol consumption.

Parental support and control and early adolescent smoking: a longitudinal study

The aim of this study is to examine the role of parental support and control on young adolescent smoking initiation, increase, continuation, and cessation. Longitudinal data gathered every 6 months over a one-year period were collected in Utrecht, The Netherlands, for 1,012 adolescents in 2000. Logistic regressions demonstrated that low parental control predicted adolescent smoking initiation but neither support nor control predicted adolescent smoking increase or continuation. Parental smoking status was important in adolescent smoking continuation and cessation. Suggestions based on these findings are made for prevention programs. A limitation is that the study only utilized adolescent reports.

Correspondence between proxy and self-reports on smoking in a full family study

OBJECTIVES

The present study investigated the reliability of proxy reports obtained from family members with self-reports on adolescent and parental lifetime and current smoking status.

METHODS

Data were assessed from 416 families, consisting of both biological parents and two adolescent siblings aged 13-17 years. These families were assessed at baseline and 1 year later. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to test whether proxy reports corresponded with self-reports.

RESULTS

Mothers scored higher than fathers on most measures on lifetime and current smoking status of both children. The sensitivity was low for parental reports, but moderate to high for children's reports. Specificity and positive predictive value were high in all proxy reports. The negative predictive value was moderate (parents as proxy reporters) to low (children as proxy reporters) on lifetime smoking, but high on current smoking.

CONCLUSIONS

Adolescents, aged 13-17 years, can be used as a reliable source to assess the smoking status of their mothers and fathers. Parents, however, appeared to accurately identify the smoking status of their adolescent children less reliably.

Are anti-smoking parenting practices related to adolescent smoking cognitions and behavior?

The aim of this study was to explain the effects of anti-smoking parenting practices on adolescent smoking cognitions and behavior by showing the mediating effects of cognitions. Data were gathered among Dutch high school students in the control condition of the European Smoking prevention Framework Approach (ESFA). Anti-smoking parenting practices were measured by parental reactions to smoking, house rules, and frequency and content of communication about smoking. Attitudes, perceived social influences and self-efficacy made up for smoking cognitions. Additionally, intention to smoke was measured. Relations between practices and cognitions were mostly significant. While some practices were associated with less smoking (communication about health risks of smoking, health risks of breathing in smoke, addictive qualities of smoking and attention for smoking in school), others were related to increased chances of smoking (rewards for not smoking, frequency of communication about smoking, communication about being allowed to smoke, price of cigarettes and friends smoking). The effects of parenting hardly varied by parental smoking status or adolescent gender. Several practices operated through cognitions, which was more pronounced in older adolescents. Counter-productive effects of practices and the few effects in the longitudinal analyses indicate that the order in which parents and adolescents influence each other should be examined more closely.