Associations of parental smoking throughout childhood with adolescent smoking and vaping: Mediation via adolescent substance use attitudes.

Abstract

Adolescent cigarette smoking continues to be a significant public health concern, and vaping or the use of e-cigarettes can have adverse health consequences for adolescents. Parental smoking is a key predictor of adolescent smoking, yet limited research has examined both maternal and paternal smoking throughout childhood in relation to both adolescent smoking and vaping while testing for mediation of these intergenerational effects. This study investigated cumulative exposure to maternal and paternal smoking from the prenatal period through the elementary school years in relation to adolescent cigarette and e-cigarette use, and tested adolescent cigarette and e-cigarette use attitudes as mediators. Participants were 230 children and their mothers/maternal caregivers from a Midwestern U.S. city enrolled in a longitudinal study extending from preschool through adolescence. Mothers/maternal caregivers reported on their smoking at the prenatal period (retrospectively) and on their own and their spouse's (father/paternal caregiver) smoking at the preschool and elementary school periods. Data were summed into separate cumulative indices. Adolescent cigarette and e-cigarette use over the last year and attitudes toward cigarette and e-cigarette use were assessed via phone interviews at ages 14-18 years. Path analysis was conducted. Paternal cumulative smoking had statistically significant indirect effects on both adolescent smoking and vaping through adolescent cigarette and e-cigarette use attitudes, respectively. Findings highlight the long-term risks of persistent exposure to paternal smoking for adolescent-age offspring and suggest the value of family-focused prevention strategies to mitigate these risks.