Childhood self-regulatory skills predict adolescent smoking behavior

Background: This study examines the relationship between domains of self-regulation (emotion, attention, behavior, and social, as well as a global composite) in childhood and the risk of becoming a regular smoker (minimum 1 cigarette/day for 30 days) as an adolescent. Given that 80% of adult smokers began smoking in adolescence, this research informs a lifecourse approach to smoking prevention. Methods: We used data from 2245 children (ages 3-12 at Wave 1 (1997)) in the Panel Study of Income Dynamics Child Development Supplement. From parent-reported behaviors, we derived novel multidimensional measures of regulatory capacity; higher scores indicate dysregulation. In Waves 2 (2002) and 3 (2007), youth 12-18 years self-reported their smoking behavior. Logistic regressions, adjusted for potential confounders including age, race, sex, parent smoking status and income, modeled the association between a one-unit difference in childhood self-regulatory capacity and adolescent smoking status. Results: All four domains of self-regulation, plus the global measure, were protective against smoking regularly during adolescence. Of the four discrete domains, behavioral dysregulation was the most strongly associated with subsequent smoking (OR=1.62, p<.0001). Dysregulation in the emotion (OR=1.43, p=.0032), attention (OR=1.48, p=.0002), social (OR=1.48, p=.0004), and global (OR= 1.77, p<.0001) domains was also associated with risk of future smoking. Conclusions: The development of effective self-regulation in childhood reduces the risk of becoming a regular smoker 5-10 years later. Already recognized as a key component of children's social and emotional development, self-regulation should receive greater attention as a protective factor against early adoption of poor health behaviors.