Influences of home smoking restrictions on adolescent smoking initiation in a national sample over five years

Background: Home smoking restrictions (HSR) are well established in reducing second hand smoke exposure. There is limited evidence that HSR might also reduce adolescent smoking; however longitudinal data is needed to infer causation. Differentiation between the effects of complete and partial restrictions is needed. Family agreement about the presence of HSR may indicate the strength of the rule and influence adolescent behavior. Methods: The national Parenting Project enrolled 1036 parent and teen dyads to participate in a computer assisted telephone intervention to support best parenting practices, and has been followed for six surveys. Self-reported data was obtained from both parents and adolescents on: demographics, HSR, family, peer, and tobacco-risk behaviors. Results are analyzed using SAS 9.1. Frequencies generated descriptive statistics, chi-square tests assessed for associations between all variables, and multiple logistic regression will explore for associations between home smoking restrictions and adolescent tobacco use, adjusting for covariates by June 2011. Results: In the chi-square analysis, parents and adolescents who agreed at baseline that there were complete HSR were least likely to have smoked five years later (21.1%) compared to those who agreed there were no (57.14%). Approximately 40% of adolescents whose parents agreed there were partial HSR or were in disagreement had ever smoked. Conclusions: While partial restrictions may offer some protection against future adolescent smoking behavior, it is likely complete HSR may have the strongest impact compared to those without restrictions. The impact of HSR appears reduced when parents and adolescents are in disagreement about the type of restriction.