General parenting, smoking-specific parenting practices and adolescent smoking in Hong Kong

Abstract

Introduction Though the associations of general parenting styles and smoking-specific parenting practices with adolescent smoking have received much attention in recent years, important questions remain. Most general parenting studies focused on Caucasian parents but much less in the literature is known about Chinese parents. As for smoking-specific parenting practices in the household, anti-smoking practices have been the focus, with pro-smoking practices seldom being studied.

The objectives of the present study were: 1) to examine general parenting styles of Hong Kong fathers and mothers, and their associations with adolescent current smoking; 2) to explore potential effect modifiers of the above associations—age/sex of the adolescent and parental smoking status; 3) to estimate the prevalence of adolescents’ exposure to smoking-specific parenting practices and the coexistence of pro-smoking and anti-smoking practices within a family; and 4) to examine the associations of smoking-specific parenting practices with adolescent current smoking status and their intention to smoke.

Methods Data from 2 large-scale school surveys were used. In the Hong Kong Student Obesity Surveillance project (HKSOS), 34,678 secondary students aged 12-17 completed an anonymous questionnaire. Current smoking denoted any smoking in the past 30 days. The parenting style of each parent was classified as authoritative (high care/high control), authoritarian (low care/high control), permissive (high care/low control) or neglectful (low care/low control). Binary logistic regressions generated adjusted odds ratios (AORs) of current smoking for parenting styles, and parental care and control. In the Youth Smoking Survey (YSS) (2003/04), information of adolescent smoking behaviours, their exposure to smoking-specific parenting practices at home and socio-demographic characteristics was collected among 36,612 secondary 1-5 students. Pro-smoking practices included “buy cigarettes/hand cigarettes/light a cigarette/clean the ashtray for family members”, “easily see packages of cigarettes of family members at home”, “exposure to secondhand smoke at home” and “smoking among family members”. Anti-smoking practices were “parent-child communication about harms of smoking” and “anticipated control from father/mother if you were to smoke”. AORs of adolescent current smoking and their intention to smoke for each pro-smoking and anti-smoking practice were calculated.

Results In HKSOS, over half of the fathers (51.5%) and mothers (66.2%) were authoritative. Current smoking (3.1%) was associated with lower levels of care both from father and mother, lower levels of maternal control, but higher levels of paternal control. Compared with authoritative fathers, the AORs (95% CI) of adolescent current smoking were 0.74 (0.59-0.93) for permissive, 1.13 (0.87-1.43) for authoritarian, and 0.99 (0.77-1.28) for neglectful. The corresponding AORs for mothers were 1.30 (1.04-1.61), 1.80 (1.34-2.41), and 2.49 (1.90-3.28). In YSS, 9.7% of adolescents were current smokers and 33.2% had the intention to smoke. About half the students (52.7%) reported pro-smoking practices and 87.8% reported anti-smoking practices at home. Anti-smoking practices were associated with lower odds of adolescent current smoking and intention to smoke, whereas pro-smoking practices were linked to higher odds.

Conclusions Authoritative mothers and permissive fathers seemed to have protective effects against adolescent smoking. Pro-smoking practices were associated with higher odds of adolescent current smoking and intention to smoke, while anti-smoking practices were protective.