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Open Access 01-04-2012

Smoking onset and the time-varying effects of self-efficacy, environmental smoking, and smoking-specific parenting by using discrete-time survival analysis

Authors: Marieke Hiemstra, Roy Otten, Rutger C. M. E. Engels

Published in: Journal of Behavioral Medicine | Issue 2/2012

Abstract

This study examined the timing of smoking onset during mid- or late adolescence and the time-varying effects of refusal self-efficacy, parental and sibling smoking behavior, smoking behavior of friends and best friend, and parental smoking-specific communication. We used data from five annual waves of the ‘Family and Health’ project. In total, 428 adolescents and their parents participated at baseline. Only never smokers were included at baseline (n = 272). A life table and Kaplan–Meier survival curve showed that 51% of all adolescents who did not smoke at baseline did not start smoking within 4 years. The risk for smoking onset during mid- or late adolescence is rather stable (hazard ratio between 16 and 19). Discrete-time survival analyses revealed that low refusal self-efficacy, high frequency of communication, and sibling smoking were associated with smoking onset one year later. No interaction effects were found. Conclusively, the findings revealed that refusal self-efficacy is an important predictor of smoking onset during mid- or late adolescence and is independent of smoking-specific communication and smoking behavior of parents, siblings, and (best) friend(s). Findings emphasize the importance of family prevention programs focusing on self-efficacy skills.

Interaction effects of quality of communication and frequency of communication with smoking behavior of the parent, smoking behavior of sibling, and smoking behavior of (best) friends were also tested (i.e., quality/frequency of communication * parental smoking, quality/frequency of communication * best friends smoking, quality/frequency of communication * sibling smoking). No moderation effects were found.

We tested the relationship between quality and frequency of communication at current time point and adolescent smoking behavior at previous time point, while controlling for quality and frequency of communication at previous time points. We found that when a child started smoking, the following year frequency of communication would increase. We also found an inverse relationship between child smoking and quality of communication. Particularly, when a child started smoking, quality of communication would be lower the following year. Perhaps, the quality of communication decreases after children started smoking because parents no longer see the need of qualitative communication, while at the same time they may even be more likely to emphasize that smoking is a bad habit with serious health consequences, explaining the increasing frequency of communication levels. More research is necessary to test these and related hypotheses.

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Title: Smoking onset and the time-varying effects of self-efficacy, environmental smoking, and smoking-specific parenting by using discrete-time survival analysis
Authors: Marieke Hiemstra
Roy Otten
Rutger C. M. E. Engels
Publication date: 01-04-2012
Publisher: Springer US
Published in: Journal of Behavioral Medicine / Issue 2/2012
Print ISSN: 0160-7715
Electronic ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-011-9355-3

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Smoking onset and the time-varying effects of self-efficacy, environmental smoking, and smoking-specific parenting by using discrete-time survival analysis

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