Literature review on family influence on smoking behaviour among adolescents

Abstract

Background: Smoking has long been one of the principal causes for morbidity and mortality and is ranked as the third leading cause for preventable health deaths in the world, posting serious threat to public health. Most smokers start smoking during adolescence. Adolescence describes teenagers aged 13-19 years old which can be considered as the transitional period from childhood to adulthood, about 88% of adult smokers who smoke daily started their smoking behavior by age of 18 years old and 68.2% of smokers started smoking below age of 20 in Hong Kong. Therefore, there is an urgent need to direct the public health effort towards the prevention of smoking in adolescents. It has been found that family has important influences on smoking behavior among adolescents.

Objective: The objective of this review is to examine the effect of family influences on adolescents smoking behavior, particularly the association of parenting style, parental smoking and adolescent smoking behavior.

Methods: he online databases PsycINFO, Medline and EMBASE were searched by using keywords “adolescents smoking” or “youth smoking” and “family influence” or “parental influence”. The last search was done on 10th August, 2013. Total 13 English articles, of which 10 were cross-sectional studies and 3 were longitudinal studies, were included in this review.

Results: Literature showed authoritative parenting style could reduce the risk of smoking among adolescents; all studies showed authoritative parenting style, disapproval to smoke with higher level of parental monitoring could reduce risk of regular smoking behavior among adolescents. On the other hand, results from articles examining the association of parental smoking and smoking behavior among their children were almost homogenous. Adolescents who lived with smoking parents were more likely to initiate the smoking behavior compared to those with non-smoking family members. Meanwhile, studies showed adolescents from single-parent families were more likely to smoke when compared with those came from complete family. A negative association between single parent and daily smoking was observed among the adolescents.

Conclusion: Future campaigns on smoking prevention should increase the involvement of family members, encourage parents to quit smoking and act as role model to their children; parents are suggested to practice authoritative parenting which will increase the acceptance of adolescents to their rules and suggestions and thus, avoid them from smoking. On the other hand, adolescents from single-parents are more likely to attain smoking and should increase awareness. More local researches, with randomized control trial studies, are needed in the future to examine family influences that fit the situation in Hong Kong. The aim of campaign is to further decrease smoking prevalence in adolescents.