{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T19:23:08Z","timestamp":1773948188658,"version":"3.50.1"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Children of people who smoke are more likely to take up smoking themselves. In Aotearoa New Zealand (NZ), adolescent smoking declined dramatically between 2000 and 2016 despite limited change in parental smoking, demonstrating that the cycle can be broken.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>This study aimed to identify modifiable factors associated with never smoking in Year 10 students (14\u201315 years) who had at least one caregiver who smoked. We used data from the Youth Insights Survey (2016 and 2018, pooled, N\u2005=\u20055,422) and identified students with at least one caregiver (mother, father, grandparent, other caregiver) who smoked (N\u2005=\u20052,205). To investigate modifiable factors potentially associated with nonsmoking we used logistic regression with marginally adjusted prevalence estimates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 41% of students had at least one caregiver who smoked. In this group, the majority (65%) had never smoked themselves. After adjustment, never-smoking was more prevalent among students attending low-deprivation (more affluent) schools (73% had never smoked) compared to high-deprivation schools (44%); students not exposed to others\u2019 smoking inside the home (72%) or in cars (70%) in the past week compared to those exposed (59% and 51%, respectively); and students whose parents would be upset if they were caught smoking (68% vs 49% for those whose parents would not be upset), or who had high self-esteem (69% vs 55% for those with low self-esteem).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Modifiable factors independently associated with non-smoking in adolescents with caregiver(s) who smoked were: nonexposure to smoking inside the home and in cars, parental expectations of nonsmoking, and high self-esteem.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>Even in countries like NZ with relatively low adult smoking rates, children\u2019s exposure to caregiver smoking may be prevalent, particularly in structurally disadvantaged populations. This study suggests that action to promote smokefree homes and cars, build high self-esteem in young people, and communicate expectations of non-smoking are likely to help children of people who smoke to remain nonsmokers. A comprehensive approach that also addresses \u201cupstream\u201d factors (eg, socioeconomic deprivation) and underlying causes of structural inequity (eg, institutional racism) is needed. Such policy and community action may help to break intergenerational cycles of tobacco use and health inequity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntad148","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T22:59:52Z","timestamp":1692226792000},"page":"102-110","source":"Crossref","is-referenced-by-count":3,"title":["Addressing Intergenerational Inequity in Tobacco-Harm: What Helps Children of Smokers to Remain Nonsmokers?"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4717-5495","authenticated-orcid":false,"given":"Jude","family":"Ball","sequence":"first","affiliation":[{"name":"Department of Public Health, University of Otago , Wellington , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Otago , Wellington , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Stanley","sequence":"additional","affiliation":[{"name":"Dean\u2019s Department, University of Otago , Wellington , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Waa","sequence":"additional","affiliation":[{"name":"Eru P\u014dmare M\u0101ori Health Research Centre, University of Otago , Wellington , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sue","family":"Crengle","sequence":"additional","affiliation":[{"name":"Ng\u0101i Tahu M\u0101ori Health Research Unit, University of Otago , Dunedin , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2264-9823","authenticated-orcid":false,"given":"Richard","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Otago , Wellington , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"issue":"10","key":"2023122114163264300_CIT0001","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1136\/thx.2010.153379","article-title":"Exposure to parental and sibling smoking and the risk of smoking uptake in childhood and adolescence: A systematic review and meta-analysis","volume":"66","author":"Leonardi-Bee","year":"2011","journal-title":"Thorax."},{"key":"2023122114163264300_CIT0002","volume-title":"Inquiry into the tobacco industry in Aotearoa and the consequences of tobacco use for M\u0101ori. 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