Institute of Applied Health Research, University of Birmingham, Birmingham, West Midlands, UK.
Department of Epidemiology and Public Health, University College London, London, UK.
Eur J Public Health. 2017 Aug 1;27(4):723-728. doi: 10.1093/eurpub/ckw265.
Parental separation or divorce is a known risk factor for poorer adult health. One mechanism may operate through the uptake of risky health behaviours, such as smoking. This study investigated the association between parental separation and adult smoking in a large British birth cohort and also examined potential socioeconomic, relational and psychosocial mediators. Differences by gender and timing of parental separation were also assessed.
Multiply imputed data on 11 375 participants of the National Child Development Study (the 1958 British birth cohort) were used. A series of multinomial logistic regression models were estimated to investigate the association between parental separation (0-16 years) and adult smoking status (age 42), and the role of potential socioeconomic, relational and psychosocial mediators.
Parental separation in childhood was associated with an increased risk of being a current (RRR = 2.14, 95% CI: 1.77, 2.60) or ex-smoker (RRR = 1.50, 95% CI: 1.22, 1.85) at age 42. This association remained after consideration of potential socioeconomic, psychosocial and relational mediators. Relational (parent-child relationship quality, parental involvement and adult partnership status) and socioeconomic factors (overcrowding, financial hardship, housing tenure, household amenities, free school meal receipt and educational attainment) appeared to be the most important of the groups of mediators investigated. No differences by gender or the timing of parental separation were observed.
Parental separation experienced in childhood was associated with increased risk of smoking. Families undergoing separation should be further supported in order to prevent the uptake of smoking and to prevent later health problems.
父母离异是成年后健康状况较差的已知风险因素之一。一个可能的机制是通过采取危险的健康行为，如吸烟。本研究调查了在一个大型英国出生队列中父母离异与成年吸烟之间的关系，并探讨了潜在的社会经济、关系和心理社会因素的中介作用。还评估了性别和父母离异时间的差异。
使用了全国儿童发展研究（1958 年英国出生队列）11375 名参与者的多重插补数据。估计了一系列多项逻辑回归模型，以调查父母离异（0-16 岁）与成年吸烟状况（42 岁）之间的关系，以及潜在的社会经济、关系和心理社会因素的作用。
儿童时期的父母离异与 42 岁时成为当前吸烟者（RRR=2.14，95%CI：1.77，2.60）或前吸烟者（RRR=1.50，95%CI：1.22，1.85）的风险增加有关。在考虑了潜在的社会经济、心理社会和关系因素后，这种关联仍然存在。关系因素（亲子关系质量、父母参与度和成年伴侣关系状况）和社会经济因素（过度拥挤、经济困难、住房保有率、家庭设施、获得免费校餐和教育程度）似乎是所研究的中介因素组中最重要的因素。没有观察到性别或父母离异时间的差异。
儿童时期经历父母离异与吸烟风险增加有关。应进一步支持正在经历离异的家庭，以防止吸烟的发生，并预防以后的健康问题。
