A Revisit: What is the Best Predictor of Smoking Initiation?

It has been well-established that daily smokers most frequently began smoking prior to age 18, and smoking habits in peers are among the greatest predictors in whether or not adolescents will begin to smoke (Mahabee-Gittensa, Xiao, Gordon & Khoury, 2013).  The adolescent years are dominated by emotions centred around social acceptance and the need to fit in with peers (Mahabee-Gittensa et. al, 2013).  With peer influences being so prominently known as the main predictor for smoking initiation, the important role played by parents in protecting against smoking initiation is downplayed.

That is not the sole reason why parents consistently play second fiddle to peers in population-based efforts to prevent smoking initiation.  There is a common belief that rules set by parents are ineffective with respect to regulating behaviours in teens, because adolescence is a period during which individuals are in the pursuit of increasing autonomy (Mahabee-Gittensa et. al, 2013).  Additionally, it would be plausible for some to argue that parents are minimally influential in determining the peer groups their son or daughter tends to associate with.

A recent study found that while having peers who smoked proved to put one at the greatest risk for smoking imitation, the effect was found to be significant only until mid-adolescence, or around age 15 (Mahabee-Gittensa et. al, 2013).  During those same years, parental monitoring, punishment for smoking, and perceived connectedness to parents also proved to contribute significantly to the risk of smoking initiation (Mahabee-Gittensa et. al, 2013).  Contrary to findings surrounding the temporal effects of peer influences that begin in early adolescence and diminish past mid-adolescence, parental education and monitoring were found to protect against smoking initiation before adolescence and well past the age of 15 (Mahabee-Gittensa et. al, 2013).  This implies a lasting effect of parents on the risk of smoking initiation, while peer influences only appear to showcase their true potential during the critical period from early- to mid-adolescence.

Despite the common belief that adolescents increasingly seek autonomy from their parents, it has been found that parents contribute greatly to a teen’s choice of friends (Mahabee-Gittensa et. al, 2013).  This illustrates that the most powerful predictor of smoking initiation (peer influences) is itself greatly influenced by parents, suggesting that indirectly, parents may actually be the most influential with regards to the risk of smoking initiation.  This phenomenon has been demonstrated through the increased tendency for children of parents with low education, socioeconomic status, and discipline to associate with troubled peer groups who are also much more likely to smoke (Mahabee-Gittensa et. al, 2013).  Also, one may reasonably argue that under certain circumstances, social risk factors could potentially exacerbate or even confound the influences of parenting.

The findings in this study have important implications for public health approaches taken in the prevention of smoking initiation, the most critical of which is that the role of parents should be taken as seriously as the peer groups of teens.  The authors of the article suggest that a successful intervention aimed at preventing smoking initiation should target both parents and peer groups (Mahabee-Gittensa et. al, 2013).  While I agree with the authors, I would also include social risk factors as a third consideration in smoking-prevention interventions, in addition to parents and peer groups.

References

Mahabee-Gittensa, M., Xiao, Y.,  Gordon, J., Khoury, J. (2013). The Dynamic Role of Parental Influences in Preventing Adolescent Smoking Initiation. Addictive Behaviours, 38(4), 1905-1911