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Parental anti-smoking encouragement as a longitudinal predictor of young adult cigarette and e-cigarette use in a US national study.

INTRODUCTION
Young adulthood is a critical period for the adoption of risk behaviors like tobacco use. Protective factors in adolescence may promote a tobacco-free transition to young adulthood. We examine associations between the frequency of parental anti-smoking encouragement in adolescence and cigarette and e-cigarette use in young adulthood.


METHODS
We analyzed data from Waves 1 (2009-10, 10 th grade, mean age=16.2 years) and 5 (2013-14 mean age=20.3 years) of the U.S. nationally representative NEXT Generation Health Study (n=1,718). At Wave 1, participants reported how often their parents/guardians encourage them to not smoke cigarettes (1=Rarely/never, 7=Frequently). We used separate weighted multiple logistic regressions to model Wave 5 past-30-day cigarette and e-cigarette use as functions of the frequency of parental anti-smoking encouragement at Wave 1, adjusting for sociodemographic and parenting factors, initial substance use, and peer tobacco use.


RESULTS
The average frequency of parental encouragement to not smoke cigarettes was fairly high (mean=5.35). At Wave 5, 24.7% and 14.2% of respondents reported cigarette e-cigarette use in the past 30 days, respectively. Greater frequency of parental anti-smoking encouragement was associated with lower odds of subsequent cigarette smoking (AOR 0.91, 95% CI 0.83, 0.99) but its association with e-cigarette use was not significant (AOR 0.93, 95% CI 0.84, 1.04).


CONCLUSIONS
The longitudinal negative association between anti-smoking encouragement and cigarette use suggests that parental anti-tobacco communication could be a long-term protective factor against young adult tobacco use. Our findings may also suggest the importance of product-specific messages in the evolving tobacco use landscape.


IMPLICATIONS
This study builds upon prior investigations of parenting in adolescence as a protective factor against young adult risk behavior. We isolate the frequency of anti-smoking encouragement during adolescence as an actionable factor distinct from other parenting variables. Our findings also suggest that message specificity may be an important factor in parental anti-tobacco communication as youth and young adult tobacco use becomes increasingly dominated by e-cigarettes.