Objective-Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relation between parental smoking and the risk of smoking initiation during adolescence. This study investigates unresolved issues concerning the strength and nature of the association between parent smoking and offspring smoking initiation.Methods-We enrolled 564 adolescents aged 12-17, along with one of their parents, into the New England Family Study between [2001][2002][2003][2004]. Lifetime smoking histories were obtained from parents and their adolescent offspring. Discrete-time survival analysis was used to investigate the influence of parental smoking histories on the risk of adolescent smoking initiation.Results-Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring (odds ratio=2.81, 95% CI=1.78, 4.41). In addition, the likelihood of offspring smoking initiation increased with the number of smoking parents and the duration of exposure to parental smoking, suggesting a dose-response relation between parental smoking and offspring smoking. Offspring of parents who had quit smoking were no more likely to smoke than offspring of parents who had never smoked. The effects of parental smoking on offspring initiation differed by sex (with a stronger effect of father's smoking on boys than girls), developmental period (with a stronger effect of parental smoking before the adolescent was age 13 than afterwards), and residence of parents (with effects of father's smoking being dependent on living in the same household as the adolescent). Parental smoking was also associated with stronger negative reactions to adolescents' first cigarette, a potential marker of the risk of progression to higher levels of use.Conclusions-Parental smoking is an important source of vulnerability to smoking initiation among adolescents, and parental smoking cessation might attenuate this vulnerability. KeywordsSmoking; adolescents; parent-offspring transmissionMost adult smokers began smoking during adolescence; 1-3 preventing adolescent smoking initiation is therefore important for reducing the public health burden of smoking-related illnesses over the life course. There is accumulating evidence that parental smoking increases the risk for adolescent smoking initiation; 4-19 however, unresolved issues persist concerning the strength and nature of the association between parent smoking and initiation of smoking in offspring. 20 For example, while parental smoking and parental nicotine dependence have each been linked with an increased risk of offspring smoking, 21,22 few studies of intergenerational transmission have addressed their comparative effects. Evidence from one such study suggests that the effect of maternal smoking on offspring smoking is largely irrespective of maternal nicotine dependence. 18Prior evidence of a dose-response relationship between parental smoking and offspring initiation is also mixed. In...

Objective:To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders, motivational interviewing (MI) would lead to more and longer quit attempts, reduced smoking, and more abstinence from smoking over a 12 month follow up. Design:Randomised control trial of MI versus brief advice (BA) for smoking cessation, with pre- and post-intervention assessment of self efficacy and intentions to change, and smoking outcome variables assessed at one, three, six, nine, and 12 month follow ups. Setting:A private, university affiliated psychiatric hospital in Providence, Rhode Island, USA. Patients or other participants:Consecutive sample (n = 191) of 13–17 year olds, admitted for psychiatric hospitalisation, who smoked at least one cigarette per week for the past four weeks, had access to a telephone, and did not meet DSM-IV criteria for current psychotic disorder. Interventions:MI versus BA. MI consisted of two, 45 minute individual sessions, while BA consisted of 5–10 minutes of advice and information on how to quit smoking. Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge. Main outcome measures:Point prevalence abstinence, quit attempts, changes in smoking rate and longest quit attempt. Proximal outcomes included intent to change smoking behaviour (upon hospital discharge), and self efficacy for smoking cessation. Results:MI did not lead to better smoking outcomes compared to BA. MI was more effective than BA for increasing self efficacy regarding ability to quit smoking. A significant interaction of treatment with baseline intention to quit smoking was also found. MI was more effective than BA for adolescents with little or no intention to change their smoking, but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking. However, the effects on these variables were relatively modest and only moderately related to outcome. Adolescents with comorbid substance use disorders smoked more during follow up while those with anxiety disorders smoked less and were more likely to be abstinent. Conclusions:The positive effect of MI on self efficacy for quitting and the increase in intention to change in those with initially low levels of intentions suggest the benefits of such an intervention. However, the effects on these variables were relatively modest and only moderately related to outcome. The lack of overall effect of MI on smoking cessation outcomes suggests the need to further enhance and intensify this type of treatment approach for adolescent smokers with psychiatric comorbidity.

Researchers' understanding of the impact of sociocultural and psychological factors on the various stages of adolescent smoking uptake is limited. Using national data, the authors examined transitions across smoking stages among adolescents (N = 20,747) as a function of interpersonal, familial, and peer domains. Peer smoking was particularly influential on differentiating regular smoking, whereas alcohol use was most influential on earlier smoking. Although significant, depression and delinquency were attenuated in the context of other variables. Higher school grade was more likely to differentiate regular smoking from earlier smoking stages, whereas African American ethnicity and connectedness to school and family were protective of smoking initiation. Results lend support for an interactional approach to adolescent smoking, with implications for stage-matched prevention and intervention applications.

No abstract