Intergenerational Patterns of Smoking and Nicotine Dependence Among US Adolescents

Am J Public Health. 2015 Nov;105(11):e63-72. doi: 10.2105/AJPH.2015.302775. Epub 2015 Sep 17.


Objectives: We examined associations between parental and adolescent smoking and nicotine dependence in the United States.

Methods: We used data from the 2004 to 2012 National Survey on Drug Use and Health, which ascertained smoking behaviors of 1 parent and 1 adolescent aged 12 to 17 years in 35 000 dyads. We estimated associations between parental and adolescent smoking behaviors, adjusted for covariates.

Results: Parental current dependence was strongly associated with adolescents' lifetime smoking (adjusted odds ratio [AOR] = 2.96; 95% confidence interval [CI] = 2.47, 3.55), whereas parental current nondependent smoking (AOR = 2.26; 95% CI = 1.92, 2.67) and former smoking (AOR = 1.51; 95% CI = 1.31, 1.75) were less strongly associated. Only parental nicotine dependence was associated with adolescent nicotine dependence (AOR = 1.66; 95% CI = 1.00, 2.74). Associations between parental and adolescent smoking did not differ by race/ethnicity. Parents' education, marital status, and parenting and adolescents' mental health, beliefs about smoking, perception of schoolmates' smoking, and other substance use predicted adolescent smoking and dependence.

Conclusions: Reducing parental smoking would reduce adolescent smoking. Prevention efforts should encourage parental smoking cessation, improve parenting, address adolescent mental health, and reinforce adolescents' negative beliefs about smoking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Adult
  • Child
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Odds Ratio
  • Parents*
  • Smoking / epidemiology*
  • Socioeconomic Factors
  • Tobacco Use Disorder / epidemiology*
  • United States / epidemiology