Can mental health competence reduce the higher risk of smoking initiation among teenagers with parents who smoke?

Pearce, A. , Rougeaux, E., Deighton, J., Viner, R. M., Law, C. and Hope, S. (2021) Can mental health competence reduce the higher risk of smoking initiation among teenagers with parents who smoke? European Journal of Public Health, 31(4), pp. 756-763. (doi: 10.1093/eurpub/ckab102) (PMID:34535992) (PMCID:PMC8561261)

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Background: Parental smoking strongly influences adolescent smoking, yet few studies have examined factors that may protect against this. We investigated whether skills-based components of positive mental health (‘mental health competence’, MHC) modified the association between parental and teenager smoking, in the UK-representative Millennium Cohort Study (approximately 18 000 children, born 2000–02; analytic sample: n = 10 133). Methods: Cohort members (CMs) reported at 14 years (y) whether they had ever smoked cigarettes. A dichotomized variable indicated whether one/both parents smoked when CMs were 11 y. A four-class latent MHC measure captured learning skills and prosocial behaviours at 11 y: High, High–Moderate, Moderate, Low. We examined effect measure modification (on the additive scale) by comparing risk differences (RDs) for CM smoking according to parental smoking, within each MHC class. We then estimated RDs for CM smoking according to combinations of parental smoking and MHC. Analyses accounted for confounding, sample design, attrition and item missingness. Results: CMs were more likely to smoke cigarettes if their parent(s) smoked (27%) than CMs with no parent(s) who smoked (11%; RD: 16%). When stratified by MHC, RDs were stronger for low MHC (21%; 95% CI 11–31%) than other MHC classes (ranging: 7–11%). Compared to CMs with high MHC and non-smoker parents, those with low MHC and parent(s) who smoked had an RD of 28% (95% CI 20–36%). This was greater than the sum of RDs for those with low MHC and non-smoker parent(s) [7% (2–14%)] plus those with high MHC and whose parent(s) smoked [11% (7–15%)]. There was limited effect measure modification by moderate or High–Moderate MHC. Conclusion: Improving MHC to moderate levels may help reduce intergenerational transference of smoking.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Pearce, Dr Anna
Authors: Pearce, A., Rougeaux, E., Deighton, J., Viner, R. M., Law, C., and Hope, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:European Journal of Public Health
Publisher:Oxford University Press
ISSN (Online):1464-360X
Published Online:18 September 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in European Journal of Public Health 31(4): 756-763
Publisher Policy:Reproduced under a Creative Commons License
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174091Improving life chances & reducing child health inequalities: harnessing the untapped potential of existing dataAnna PearceWellcome Trust (WELLCOTR)205412/Z/16/ZSHW - MRC/CSO Social & Public Health Sciences Unit
3048230021Inequalities in healthAlastair LeylandMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
3048230071Inequalities in healthAlastair LeylandOffice of the Chief Scientific Adviser (CSO)SPHSU17HW - MRC/CSO Social and Public Health Sciences Unit