Department of Clinical and Biological Sciences, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy.
Eur Child Adolesc Psychiatry. 2021 Jan;30(1):105-115. doi: 10.1007/s00787-020-01489-5. Epub 2020 Feb 20.
Adolescent smoking is a major public health problem. While the socioeconomic status (SES) of the neighbourhood and that of the family are known to play a role in smoking onset and progression, it is not clear whether it modifies the association between parental influences and adolescent behaviour. The purpose of this study is to investigate family correlates of adolescent smoking experimentation and to explore the modifying role of socioeconomic context and European geographical area in a sample of European adolescents. This is a secondary analysis of the baseline survey of the European Drug Addiction Prevention (EU-Dap) trial which took place in seven European countries and involved 7079 students. School SES was used as indicator of socioeconomic context. European countries were aggregated in two geographical areas: North-Central and South. The associations between parental, family factors, and adolescents smoking experimentation were analysed through multilevel mixed-effect logistic regression models, stratified by school SES and European geographical area. Parental smoking, permissiveness towards tobacco, family conflicts, problematic relationships, low connectedness, and low parental control were significantly associated with adolescent smoking experimentation. Paternal smoking was a stronger correlate of adolescent smoking in low SES schools, while maternal smoking in high SES schools. Parental permissiveness was a stronger correlate in low SES schools. Family conflicts and low parental control were correlates only in low SES schools. The associations did not substantially differ between European geographical areas, with the exception of parental smoking that was a stronger correlate in the North, and parental control that was a correlate only in the South of Europe. To reduce inequalities in tobacco-related outcomes, prevention efforts in low socioeconomic contexts appear to be a public health priority. Parental smoking, permissiveness, family relationships, and connectedness should be addressed in preventive programs.
青少年吸烟是一个主要的公共卫生问题。虽然邻里和家庭的社会经济地位（SES）已知在吸烟的开始和发展中起作用，但尚不清楚它是否会改变父母影响和青少年行为之间的关联。本研究旨在调查青少年吸烟实验的家庭相关性，并在欧洲青少年样本中探索社会经济背景和欧洲地理区域的调节作用。这是欧洲药物滥用预防（EU-Dap）试验基线调查的二次分析，该试验在七个欧洲国家进行，涉及 7079 名学生。学校 SES 被用作社会经济背景的指标。欧洲国家被分为两个地理区域：中北部和南部。通过多水平混合效应逻辑回归模型，按学校 SES 和欧洲地理区域分层，分析了父母、家庭因素与青少年吸烟实验之间的关联。父母吸烟、对烟草的宽容度、家庭冲突、有问题的关系、低联系度和低父母控制与青少年吸烟实验显著相关。父亲吸烟与低 SES 学校青少年吸烟的相关性更强，而母亲吸烟与高 SES 学校青少年吸烟的相关性更强。父母宽容度在低 SES 学校的相关性更强。家庭冲突和低父母控制仅在低 SES 学校是相关因素。除了父母吸烟在北欧更强相关，父母控制仅在南欧更强相关之外，这些关联在欧洲地理区域之间没有实质性差异。为了减少与烟草相关的结果不平等，在低社会经济环境中开展预防工作似乎是公共卫生的优先事项。在预防计划中，应解决父母吸烟、宽容度、家庭关系和联系等问题。
