Intergenerational Transfer of Tobacco Use Behaviour from Parent to Child: A Case Control Study

BACKGROUND: Parental influence may be a strong modifiable risk factor in the initiation of Tobacco habits among young adults. Parenting style may modify the risk of initiation of Tobacco use. OBJECTIVE: To examine the intergenerational transfer of Tobacco habits amongst the urban and tribal populations in Kerala. METHODOLOGY: A hospital based unmatched case control study was undertaken in urban and tribal health centres in Kerala, India. 239 cases (19-30 years of age using any form of Tobacco, 64.10% males) and 256 controls (35.90% males) were enrolled. Parental Tobacco exposure ascertainment was done by conducting in depth interviews using a validated structured questionnaire, parent bonding instrument and life grid technique. Multiple logistic regressions were performed. RESULTS: The odds of a case initiating the habit of Tobacco use was nearly four times more when the parent was a Tobacco user [adjusted OR 4.26 (95% CI 2.39 – 7.58)] as opposed to controls. Among other covariates examined, low parental bonding with subject (especially father- warmth/care) was a strong risk factor for Tobacco usage [OR 2.17 (95% 1.11 – 4.23)]. The cases had nearly four times the probability of Tobacco uptake compared to controls if the mothers had no formal schooling [adjusted OR of 3.93 (95% CI, 2.12 – 7.26)]. CONCLUSION: Parental use of Tobacco influences the uptake of Tobacco habits in their children, with the father’s parenting (low paternal warmth) being a strong risk factor.