How Children of Smokers Become Non-Smokers

A New Zealand study examined the social determinants of tobacco experimentation among children of smokers. It highlights the importance of protection from exposure to tobacco smoke, as well as parental attitudes toward tobacco and children's self-esteem.

Children of smokers are more likely to become smokers, especially if they come from a lower socioeconomic background. Ethnicity can also be a determining factor, as numerous studies have shown.

This connection was contradicted in New Zealand when regular tobacco consumption fell sharply among adolescents aged 14-15, from 22 % in 2002 to 5 % in 2015, while it declined less quickly among adults.[1]Among Maori adolescents, it fell from 43 % in 2000 to 11 % in 2016. As this trend is also observed among children of smokers, a team of New Zealand researchers explored the social determinants that may have contributed to it.

A decline in initiation also observed in ethnic minorities

Using data from the 2016 and 2018 Youth Insights Survey, the researchers focused on the 2,205 adolescents who had at least one family member (parent, stepparent, grandparent, friend, or other) who smoked, representing 41% of the total sample.[2]. This rate of at least one smoking member of the entourage rose to 63 % for Maori and Pacific ethnic adolescents, compared to 33 % for those not belonging to these ethnic groups. The smoking prevalence in New Zealand at that time was 15 % on average among adults, but taking into account a wider entourage multiplied the rate of presence of smokers.

Among these adolescents with at least one family member who smoked, 65 % had never experimented with tobacco. The factors favoring this non-experimentation were, in decreasing order of importance:

• the request made by parents not to smoke;
• non-exposure to tobacco smoke in a vehicle;
• non-exposure to tobacco smoke in the home;
• the level of self-esteem developed by adolescents.

Enrollment in a valued school was another protective factor, which was more strongly correlated with the socioeconomic level of families and therefore less easily modifiable.

These protective factors were also observed among Maori and Pacific ethnic adolescents, but the low presence of the latter in the sample made interpretation of the results cautious.

Double interest in protecting children from exposure to tobacco

Parental requests not to smoke are the most important factor and protect against smoking initiation. A more permissive parental attitude, on the other hand, results in greater experimentation with tobacco.

The researchers therefore emphasize the importance of parental instructions, but also highlight the importance of protection against exposure to tobacco smoke. Just like the rule not to smoke in the home, the ban on smoking in vehicles has thus had a dual beneficial effect, on the one hand by preventing children from being exposed to smoke, and on the other by denormalizing smoking. Health actions developed at the community level appear useful and necessary to support the decline in smoking, in ethnic minorities as in all disadvantaged social groups. The issue of self-esteem appeared particularly salient among children from these ethnic minorities, who suffer from lower social status.

These results also corroborate those of a recent Australian study, which did not observe a correlation between having a smoking parent and the susceptibility of an adolescent to becoming a smoker.[3]These two studies thus indicate that there is no inevitability in children of smokers becoming smokers.

Keywords: New Zealand, adolescents, children of smokers, protection from smoke exposure.

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[1] Ball J, Sim D, Edwards R, Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002–2015, BMJ Open 2018;8:e020320. doi:10.1136/bmjopen-2017-020320.

[2] Scully M, Greenhalgh E, Bain E, Wakefield M, Durkin S, White V, E-cigarette use and other risk factors associated with tobacco smoking susceptibility among Australian adolescents, Australian and New Zealand Journal of Public Health, published online 22 August 2023, https://doi.org/10.1016/j.anzjph.2023.100076.

[3] Scully M, Greenhalgh E, Bain E, Wakefield M, Durkin S, White V, E-cigarette use and other risk factors associated with tobacco smoking susceptibility among Australian adolescents, Australian and New Zealand Journal of Public Health, published online 22 August 2023, https://doi.org/10.1016/j.anzjph.2023.100076.