Purpose. To examine the association between household smoking restrictions and adolescent smoking, controlling for parental smoking, peer smoking, and tobacco marketing. Design. Cross-sectional analysis of 1999 data from the Growing Up Today Study, a longitudinal cohort of adolescents. Setting. Self-report questionnaire. Subjects. 10,593 adolescents aged 12 to 18 years. Measures. The dependent variable was established smoking (smoking ≥ 100 cigarettes). Variables of interest were household smoking restrictions, parental smoking, peer smoking, and tobacco promotional item (TPI) possession. Results. Four percent of participants reported that their households permitted smoking. Parental smoking, peer smoking, and TPI possession were significantly associated with established smoking. In logistic regression models adjusted for age, gender, peer smoking, and TPI possession, adolescent smoking was inversely related to the presence of a restrictive household policy (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48–0.93); however, when parental smoking was added to this model, the association was attenuated (OR = 0.94, CI = 0.65–1.35). When only one parent in the household smoked, smoking restrictions were more common when this parent was the father. Conclusions. Although household smoking restrictions offer health benefits, they do not appear to be associated with adolescent smoking after accounting for other factors. Prior studies did not include parental smoking, peer smoking, and marketing influences. This analytic difference may explain apparent contradictions in the literature.
Tobacco marketing and adolescent smoking: more support for a causal inference
