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

Document Type : Research Articles


Department of Public Health Dentistry, Amrita School of Dentistry, Amrita University, Kerala, India.


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.


Main Subjects