Does tobacco marketing undermine the influence of recommended parenting in discouraging adolescents from smoking?

OBJECTIVE: The tobacco industry contends that parenting practices, not marketing practices, are critical to youth smoking. Our objective was to examine whether tobacco-industry marketing practices undermine the protective effect of recommended authoritative parenting against adolescent smoking.

DESIGN AND SETTING: Receptivity to tobacco advertising and promotions was assessed in 1996 from a representative sample of California adolescent never-smokers aged 12 to 14 years. A follow-up survey of 1641 of these adolescents was conducted in 1999 that included measures of the key components of authoritative parenting: parental responsiveness, monitoring, and limit setting.

MAIN OUTCOME MEASURE: Smoking initiation in adolescents.

RESULTS: Adolescents in families with more-authoritative parents were half as likely to smoke by follow-up as adolescents in families with less-authoritative parents (20% vs 41%, p <0.0001). In families with more-authoritative parents, adolescents who were highly receptive to tobacco-industry advertising and promotions were significantly more likely to smoke (odds ratio=3.52, 95% confidence interval =1.10-11.23), compared to those who were minimally receptive. This effect was not significant in adolescents in families with less-authoritative parents. The overall attributable risk (adjusted for exposure to peer smokers) of smoking from tobacco-industry advertising and promotions was 25%. However, an estimated 40% of adolescent smoking in families with more-authoritative parents was attributable to tobacco-industry advertising and promotions; this was five times the attributable risk seen in families with less-authoritative parents (8%).

CONCLUSION: The promotion of smoking by the tobacco industry appears to undermine the capability of authoritative parenting to prevent adolescents from starting to smoke.