Cigarette smoking in the adolescent children of drug-abusing fathers.

Pediatrics 117.4 (April 2006): p1339(9). (6668 words)

Characteristics of the Sample Demographic information on the adolescents who participated at both time waves and their fathers indicated that 76.4% of the fathers reported a lifetime history of injection drug use at time 1; the remainder (23.6%) of the fathers had used drugs through another route of administration, such as crack smoking. A total of 85% (n = 253) had a history of cocaine use, and 73% of fathers (n = 216) reported lifetime use of heroin. A total of 77% (n = 228) of fathers reported having ever been in treatment at time 1. The average age for fathers at time 1 was 42.1 years (SD: 6.5), and their median educational level was the completion of high school or obtaining a GED. Occupational analysis indicated that only 37% of fathers were employed at the time of the interview (24% full time and 13% part time); the rest (63%) were unemployed, looking for work, retired, keeping house, or in treatment full time. Their median household income range was $10 000 to $15 000 per annum. A total of 57% of the father-child pairs resided together. The average age for the adolescents at time 1 was 16.3 years (SD: 2.8) and at time 2 was 17.2 years (SD: 2.8). A total of 51.7% of adolescent participants at time 2 were male. The median educational level for the adolescents at time 2 was the 10th grade. According to the adolescents' reports, the ethnicity of the father-child pairs was 47.3% black, 44.0% Hispanic, 7.4% non-Hispanic white, and 1.3% other.

Our results suggest that paternal tobacco and illicit drug use may have an adverse impact on the father's childrearing practices and the establishment of a predominantly warm and nonconflictual relationship with his adolescent child. Fathers who smoke cigarettes may be less likely to have or to enforce antismoking rules for their child, (55) and the adolescent may be more likely to smoke in the absence of such rules. (13) In addition, the father may be more focused on procuring and taking illegal drugs than on his child's education and welfare. The adolescent child may also have less identification (defined in our study as admiration and emulation) with a father who is abusing drugs. There is currently scant empirical research on the father-child relationship in the context of paternal drug use, (56) and even fewer studies, to our knowledge, have specifically looked at adolescent smoking as the outcome of interest. In a related vein, however, Rotheram-Borus et al (57) examined the parent-child relationship in HIV-positive mothers and fathers, most of whom were drug users, and found that current parental drug use was highly associated with parent-child conflict. Brook et al (58) also found that parental illicit drug use was inversely related to positive aspects of the parent-child bond in a community sample of young mothers and fathers and their children. In addition, our results are consistent with the few investigations of the mediational role of the parentchild relationship in the adjustment of the children of drug-using parents. Fals-Stewart et

al, (2) for instance, showed that interparental conflict and poor parenting skills linked paternal substance use with internalizing and externalizing symptoms in their preadolescent children. Similarly, Suet al (21) found that negative life events and decreased family cohesion mediated the longitudinal association between maternal and/or paternal substance use disorders and both depression in and the use of alcohol and illicit drugs by their early adolescent child. (Of note is that these researchers also found a direct link between parental and offspring substance use, similar to our own finding.) Taken together with the present study, these preliminary results on the children of drug users point to the impact of paternal drug use on the father-child relationship, as well as the importance of the father-child bond to the adolescent's psychological adjustment. Our results suggest that paternal tobacco and illicit drug use may have an adverse impact on the father's childrearing practices and the establishment of a predominantly warm and nonconflictual relationship with his adolescent child. Fathers who smoke cigarettes may be less likely to have or to enforce antismoking rules for their child, (55) and the adolescent may be more likely to smoke in the absence of such rules. (13) In addition, the father may be more focused on procuring and taking illegal drugs than on his child's education and welfare. The adolescent child may also have less identification (defined in our study as admiration and emulation) with a father who is abusing drugs. There is currently scant empirical research on the father-child relationship in the context of paternal drug use, (56) and even fewer studies, to our knowledge, have specifically looked at adolescent smoking as the outcome of interest. In a related vein, however, Rotheram-Borus et al (57) examined the parent-child relationship in HIV-positive mothers and fathers, most of whom were drug users, and found that current parental drug use was highly associated with parent-child conflict. Brook et al (58) also found that parental illicit drug use was inversely related to positive aspects of the parent-child bond in a community sample of young mothers and fathers and their children. In addition, our results are consistent with the few investigations of the mediational role of the parentchild relationship in the adjustment of the children of drug-using parents. Fals-Stewart et al, (2) for instance, showed that interparental conflict and poor parenting skills linked paternal substance use with internalizing and externalizing symptoms in their preadolescent children. Similarly, Suet al (21) found that negative life events and decreased family cohesion mediated the longitudinal association between maternal and/or paternal substance use disorders and both depression in and the use of alcohol and illicit drugs by their early adolescent child. (Of note is that these researchers also found a direct link between parental and offspring substance use, similar to our own finding.) Taken together with the present study, these preliminary results on the children of drug users point to the impact of paternal drug use on the father-child relationship, as well as the importance of the father-child bond to the adolescent's psychological adjustment.

Smoking frequency, prevalence and trends, and their socio-demographic associations in Alberta, Canada. (QUANTITATIVE RESEARCH) (Report).
As shown, both the smoking prevalence and the number of smokers were higher among men than women, in middle-aged groups (20-39 and 40-59 years) than in younger (12-19 years) and older (>60 years) groups, and among Canadian-born people than immigrants to Canada The above associations were further examined using logistic regression (Table 3). As shown, the odds of being a smoker were significantly lower in women than men and about four times higher in those aged 20-39 and 40-59 years than in those aged 12-19 years and 60 years or older.

Smoking cessation: priorities in primary care: this article will focus on the role of brief advice, before discussing specific issues relating to smoking cessation in high-prevalence groups, which include manual workers, adolescents and pregnant women.(smoking cessation).
In developed countries, there is a strong correlation between smoking and socioeconomic class, primarily because the decline in overall smoking rates seen since the middle of the 20th century has been mainly concentrated in the higher socio-economic groups. In 2002, in western Europe, the highest smoking prevalence was among the unemployed (54%) and manual workers (51%). In the UK, in 2006, 28% of manual workers smoked compared with 17% of non-manual workers, with the difference between social classes being even greater- only 15% of those in higher professional or managerial households smoked, compared to 29% in a routine or manual occupation. (5) There are also

differences in the amount smoked and the type of smoking between social classes (Table 2). Motivation to quit is similar across social groups, but poorer people who smoke cannot be blamed for failing to quit because they have lower motivation. As people from lower socio-economic backgrounds who smoke tend to be more seriously addicted to nicotine, there may be even greater justification for using pharmacotherapy in this group. (7) In the UK, the most marked reduction in the smoking rate has been among people over the age of 35 years. (8) In 2006, the lowest rate (12%) was among those aged 60 years and over, possibly because non-smokers tend to live longer. Among those aged 16-19, it was 20%, the rate remaining highest in 20-24-year-olds at 31%. (5) Children become aware of cigarettes at an early age, even if their parents do not smoke. However, children are three times more likely to smoke if their parents are smokers, while peers and older siblings are also influential. (8) At the age of 11 years, at the start of secondary school, only 1% of children are regular smokers. By the time they reach 15 years old, however, the likelihood of them smoking regularly is 20%. (9) Although in the past 10 years the proportion of teenagers who smoke has declined, most of this decrease has been in boys. The smoking rate in children gives an indication of the likely adult rate in years to come-about 40% of adult smokers started smoking before the age of 16 years. (6) Furthermore, the earlier smoking starts, the greater the potential damage. (9) Young people who smoke are aware of the health risks of smoking and most would like to stop. Although young people who smoke report smoking few cigarettes, many consider themselves to be addicted to tobacco and believe that stopping would be difficult. Young people who smoke are also more likely to drink alcohol or take illicit drugs. (7)

Tobacco, alcohol and illicit drug use among aboriginal youth living offreserve: results from the Youth Smoking Survey.(Research)(Survey
Of the 28 843 respondents in grades 9 to 12 who answered the item about Aboriginal status, 2620 (9.1%) identified themselves as Aboriginal: 1408 (53.7%) were First Nations, 962 (36.7%) were Metis and 250 were Inuit (9.5%). Table 1 presents the sample characteristics of the Aboriginal and non-Aboriginal youth in our sample by sex. Tobacco use

Overall, 24.9% of the Aboriginal respondents reported that they were current smokers, 2.6% were former smokers, and 72.4% were nonsmokers (Table 1). The corresponding proportions among the non-Aboriginal respondents were 10.4%, 1.5% and 88.0%. The prevalence of smoking was higher among female than among male Aboriginal youth (27.1% v. 22.9%; p = 0.03). Among the respondents who reported having never smoked, 33.4% of Aboriginal youth and 29.0% of non-Aboriginal youth were identified as being susceptible to future smoking.