Parents' income, education influence teen smoking

July 18, 2003

Parents with lower incomes and educational levels are more likely than higher-paid, better-educated parents to have teenage children who smoke, according to a recent study in Massachusetts.

A telephone survey of 1,308 adolescents by Elpidoforos Soteriades, M.D., M.Sc., and Joseph DiFranza, M.D., appears in the July issue of the American Journal of Public Health.

Some previous studies had tied low socioeconomic status with increased teen smoking, but others found no association. Soteriades and DiFranza say that their study is the first in the United States to connect parental income and education to adolescent smoking, even after adjusting for age, sex, race/ethnicity and other factors.

They divided parents' incomes into four categories -- those earning $20,000 or under; $20,000 to 30,000; $30,000 to $50,000; and more than $50,000. Each drop on the income scale meant a 30 percent increased risk of smoking by the teenager.

Parental education levels were categorized as less than high school; high school diploma; some college; and college graduate. Each step down the parents' education ladder meant a 28 percent increase in the risk of adolescent smoking.

A third important contributing factor was whether or not the teen's parents smoked.

"Parental smoking status is a known strong predictor of adolescent smoking and we know smoking is more prevalent among low socioeconomic status parents," said Soteriades and DiFranza.

Mothers set a particularly powerful example: Teens whose mothers smoked had an 85 percent increased risk of becoming smokers themselves.

The role of parents' smoking status suggests that tailoring smoking cessation programs for adults with low incomes or educational levels may be one way of preventing their kids from smoking.

Soteriades and DiFranza originally thought that more personal or psychological factors, like depressive symptoms or adolescent rebelliousness, might have an effect on smoking rates, but those turned out not to affect the role of the parents' socioeconomic status.

However, the amount of a teen's spending money did seem to magnify the effects of their parents' income or education on the teen's decision to smoke or not. Teens who were receiving a weekly allowance or had earned money from a job were more likely to be smokers, the researchers said.

Knowing that parental income and education can influence a child's chances of smoking may be a starting point for preventive measures, say Soteriades and DiFranza, but they may reflect other associations as well.

For instance, low socioeconomic status has been tied to eschewing preventive measures like wearing seatbelts. It may also reflect community factors such as the quality of health education in local schools and how well smoking bans are enforced there, or the availability of tobacco in the neighborhood. Kids from low socioeconomic backgrounds may also feel that life is stacked against them or don't care about their future health, so they may be less concerned in the present about the long-term consequences of smoking.

"Without an understanding of why parental socioeconomic status so strongly predicts adolescent smoking," say Soteriades and DiFranza, "it is not clear how that knowledge can be used for prevention except to provide grounds for simply targeting low-socioeconomic status populations with general preventive measures."

More research is needed to better understand the connection between low parental income and education and adolescent smoking, the researchers say.
For more information:

Health Behavior News Service: 202-387-2829 or
Interviews: Contact the University of Massachusetts Public Affairs Office at 508-856-2000.
American Journal of Public Health: 202-777-2511 or

Center for Advancing Health

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