The role of parental smoking on adolescent smoking and its social patterning: A cross-sectional survey in six European cities

Background Several studies have observed socio-economic (SE) inequalities in smoking among adolescents, but its causes are not fully understood. This study investigates the association between parental and adolescent smoking, and whether this association is socially patterned. Methods We used data from a survey administered in 2013 to students aged 14-17 years old of six European cities (n = 10 526). Using multilevel mixed-effects logistic regression, we modelled the probability of being a daily smoker as a function of parental smoking and SE status. We tested whether the smoking association differed across social strata. Results The prevalence of parental smoking was higher in low SE status adolescents. Boys and girls were more likely to smoke if they have a father [boys: adjusted odds ratio (AOR) = 1.90, 95% CI = 1.47-2.46; girls: AOR = 1.42, 95% CI = 1.09-1.86] and mother (boys: AOR = 1.77, 95% CI = 1.35-2.31; girls: AOR = 3.36, 95% CI = 2.56-4.40) who smoked. Among boys, the odds of smoking when having a smoking parent were higher in lower SE classes. However, this was not statistically significant, nor was it observed among girls. Conclusions Adolescents are more likely to smoke when their father and mother smoke. Although the susceptibility to parental smoking was similar across social classes, SE differences in parental smoking contribute to the transmission of SE inequalities in smoking.