Intergenerational Transfer of Tobacco Use Behaviour from Parent to Child: A Case Control Study.

BACKGROUND

Parental influence may be a strong modifiable risk factor in the initiation of Tobacco habits among young adults. Parenting style may modify the risk of initiation of Tobacco use.

OBJECTIVE

To examine the intergenerational transfer of Tobacco habits amongst the urban and tribal populations in Kerala.

METHODOLOGY

A hospital based unmatched case control study was undertaken in urban and tribal health centres in Kerala, India. 239 cases (19-30 years of age using any form of Tobacco, 64.10% males) and 256 controls (35.90% males) were enrolled. Parental Tobacco exposure ascertainment was done by conducting in depth interviews using a validated structured questionnaire, parent bonding instrument and life grid technique. Multiple logistic regressions were performed.

RESULTS

The odds of a case initiating the habit of Tobacco use was nearly four times more when the parent was a Tobacco user [adjusted OR 4.26 (95% CI 2.39 - 7.58)] as opposed to controls. Among other covariates examined, low parental bonding with subject (especially father- warmth/care) was a strong risk factor for Tobacco usage [OR 2.17 (95% 1.11 - 4.23)]. The cases had nearly four times the probability of Tobacco uptake compared to controls if the mothers had no formal schooling [adjusted OR of 3.93 (95% CI, 2.12 - 7.26)].

CONCLUSION

Parental use of Tobacco influences the uptake of Tobacco habits in their children, with the father's parenting (low paternal warmth) being a strong risk factor.