Parental smoking, rejection of parental smoking, and smoking susceptibility and behaviors in Hong Kong adolescents

Introduction: We explored the role of rejection of parental smoking in the association between parental smoking and smoking in adolescents. Methods: In 2010–11 cross-sectional survey, 61,810 Hong Kong secondary school students (mean age 14.6 years, 50.5% boys) reported their smoking (never, not susceptible; never, susceptible; ever, not current; current), paternal and maternal smoking, and whether they accepted paternal and maternal smoking (acceptance/rejection). We used multinomial logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of students’ smoking in relation to acceptance and rejection of parental smoking, compared with no parental smoking. Results: The OR (95% CI) of “never, susceptible” “ever, not current” and “current” compared with “never, not susceptible” in relation to acceptance of paternal smoking was 1.81 (1.67–1.96), 2.46 (2.25–2.69), and 2.79 (2.51–3.10), respectively. The corresponding ORs for rejection were 0.70 (0.64–0.76), 1.23 (1.13–1.35), and 0.47 (0.40–0.56). The OR (95% CI) of “never, susceptible” “ever, not current” and “current” compared with “never, not susceptible” in relation to acceptance of maternal smoking was 2.05 (1.80–2.33), 2.57 (2.29–2.88), and 6.33 (5.39–7.44), respectively. The corresponding ORs for rejection were 0.85 (0.69–1.05), 1.59 (1.39–1.81), and 2.14 (1.71–2.68). No overlapping was observed between the 95% CIs for acceptance and rejection of paternal or maternal smoking. Conclusions: While adolescent smoking was associated with parental smoking, especially in those who accepted parental smoking, the association was attenuated or reversed in those who rejected parental smoking.