Roy Otten

Parental Smoking and Adolescent Smoking Stages: The Role of Parents’ Current and Former Smoking, and Family Structure

This study examined the role of parents’ current and former smoking in predicting adolescent smoking acquisition stages. Participants were 7,426 students from 33 schools in the Netherlands. Participants’ survey data were gathered at baseline and at two-year follow-up. Logistic regression models showed that parental smoking status was not only predictive of transitions from never smoking to trying smoking, monthly smoking, or daily smoking, but also of the progression from trying smoking to daily smoking. Further, although parental former smoking was weaker associated with progressive adolescent smoking transitions than current parental smoking, however absence of parental smoking history was most preventive. Compared to the situation in which both parents had never smoked, cessation of parental smoking after the child was born was associated with an increased risk for children to smoke. Adolescents living in a single-parent family were at greater risk of smoking than adolescents living in an intact family with both mother and father. In sum, the role of parental smoking is not restricted to smoking onset and is present throughout different phases of the acquisition process. Results support the delayed modeling hypothesis that parental smoking affects the likelihood for children to smoke even when parents quit many years before. Children living in single-parent families are only exposed to the behaviour of one parent; in two-parent families the behaviour from one parent may magnify or buffer the behaviour of the other parent.

Frequency and Quality of Parental Communication as Antecedents of Adolescent Smoking Cognitions and Smoking Onset

The present study examines whether aspects of parental communication about smoking function as antecedents of adolescent smoking cognitions. In this longitudinal full-family study (428 families), parent and adolescent reports were used to assess parental communication. Concepts of the Theory of Planned Behavior were measured among adolescents. Differences between older and younger siblings within the family were examined. Cross-sectionally, frequency and quality of communication were associated with smoking cognitions. Longitudinally, only quality of communication preceded smoking cognitions. This effect was mainly found for younger siblings. The results of this study emphasize the importance of quality of parental communication rather than frequency. Communication patterns based on mutual respect and equality help to prevent adolescent smoking onset.

Personality and parenting style in parents of adolescents

Since parental personality traits are assumed to play a role in parenting behaviors, the current study examined the relation between parental personality and parenting style among 688 Dutch parents of adolescents in the SMILE study. The study assessed Big Five personality traits and derived parenting styles (authoritative, authoritarian, indulgent, and uninvolved) from scores on the underlying dimensions of support and strict control. Regression analyses were used to determine which personality traits were associated with parenting dimensions and styles. As regards dimensions, the two aspects of personality reflecting interpersonal interactions (extraversion and agreeableness) were related to supportiveness. Emotional stability was associated with lower strict control. As regards parenting styles, extraverted, agreeable, and less emotionally stable individuals were most likely to be authoritative parents. Conscientiousness and openness did not relate to general parenting, but might be associated with more content-specific acts of parenting.

A Prospective Study of Perception in Adolescent Smoking

PURPOSE This prospective study examined how environmental smoking affects the perception of lifetime smoking prevalence and thereby the likelihood of subsequent regular smoking. METHODS A longitudinal design (N = 6769) with three waves was used to test our research questions. Exposure to smoking by peers, best friends, and parents were assessed at T1. Perception of lifetime smoking prevalence was calculated at T2. Adolescent smoking was assessed at three waves. RESULTS Overestimation of lifetime smoking prevalence was predicted by having a predominantly smoking peer group, having a best friend who smokes, and by having at least one parent who smokes. In consistency with a false consensus effect, smokers were more susceptible to overestimate lifetime smoking prevalence than nonsmokers. Subsequently, while controlling for smoking at T2, overestimating lifetime smoking prevalence was predictive of regular smoking at T3 (in accordance with the conformity hypothesis). Specifically, overestimation of lifetime smoking appeared to mediate the effects of environmental smoking (peers, best friends, and parents) on adolescent smoking. No support was found for a moderation effect of exposure to environmental smoking on the link between misperception of lifetime smoking prevalence and regular smoking. CONCLUSIONS The study offers a rare and needed theoretical and empirical research examining environmental and individual predictors of regular smoking. Besides direct prevention of exposure to smoking, cognitions that are a product of exposure to smoking need to be addressed in prevention campaigns.

Parental Smoking and Smoking Behavior in Asthmatic and Nonasthmatic Adolescents

Background. Smoking may have serious consequences for asthmatics. Nevertheless, studies have shown that smoking behavior among asthmatics is similar to or even higher than that of nonasthmatics. Since the relationship between parental smoking and child smoking is well established, this study examined whether the association between parental and child smoking behavior is similar for asthmatic and nonasthmatic adolescents. The impact of parental smoking history was also explored. Methodology. A cross-sectional sample of 10,087 Dutch adolescents was used to assess the prevalence of asthma and smoking behavior. Moreover, respondents had to report whether one of their parents currently smoked, had stopped, or had never smoked. In case a parent was a former smoker, the respondent had to report his or her own age at the moment that the parent stopped smoking. Results. Logistic regression analyses showed that, compared with nonasthmatic adolescents, asthmatic adolescents were more likely to have smoking parents. Furthermore, similar associations were found between parental smoking and adolescent smoking among asthmatic and nonasthmatic adolescents. The time at which maternal smoking ceased was associated with a decreased likelihood for ever smoking for both asthmatic and nonasthmatic adolescents. Conclusions. Asthmatic adolescents need to become more aware of the health risks of smoking. Therefore, tailor-made antismoking campaigns are needed at schools to reduce misconceptions among asthmatic adolescents about the risks of smoking. In addition, a personal intervention approach aimed particularly at smoking parents of an asthmatic child, may make them aware of the consequences for their offspring and help them to stop smoking.

Country-level and individual correlates of overweight and obesity among primary school children: a cross-sectional study in seven European countries

BackgroundThe present study aims to estimate childhood overweight and obesity prevalence and their association with individual and population-level correlates in Eastern and Western European countries.MethodsData were obtained from the School Children Mental Health in Europe, a cross-sectional survey conducted in 2010 in Italy, Germany, the Netherlands, Romania, Bulgaria, Lithuania and Turkey. The sample consists of 5,206 school children aged 6 to 11 years old. Information on socio-demographics, children’s height and weight, life-style and parental attitude were reported by the mothers. Country-level indicators were obtained through several data banks. Overweight and obesity in children were calculated according to the international age and gender-specific child Body Mass Index cut-off points. Multivariable logistic regression models included socio-demographic, lifestyle, mothers’ attitude, and country-level indicators to examine the correlates of overweight.ResultsOverall prevalence was 15.6% (95% CI = 19.3-21.7%) for overweight and 4.9% (95% CI = 4.3-5.6%) for obesity. In overweight (including obesity), Romanian children had the highest prevalence (31.4%, 95% CI = 28.1-34.6%) and Italian the lowest (10.4%, 95% CI = 8.1-12.6%). Models in the pooled sample showed that being younger (aOR = 0.93, 95% = CI 0.87-0.97), male (aOR = 1.24, 95% CI = 1.07-1.43), an only child (aOR = 1.40, 95% CI = 1.07-1.84), spending more hours per week watching TV (aOR = 1.01, 95% CI =1.002-1.03), and living in an Eastern Country were associated with greater risk of childhood overweight (including obesity). The same predictors were significantly associated with childhood overweight in the model conducted in the Eastern region, but not in the West. Higher Gross Domestic Product and Real Domestic Product, greater number of motor and passenger vehicles, higher percentage of energy available from fat, and more public sector expenditure on health were also associated with lower risk for childhood overweight after adjusting for covariables in the pooled sample and in the east of Europe, but not in the West.ConclusionsPrevalence rates of overweight and obesity in school children is still high, especially in Eastern regions, with some socio-demographic factors and life-styles associated with being overweight. It is also in the Eastern region itself where better macro-economic indicators are related with lower rates of childhood overweight. This represents a public health concern that deserves special attention in those countries undertaking economic and political transitions.

The role of coping strategies in quality of life of adolescents with asthma

This study aimed to determine which coping strategies are associated with better quality of life (QOL) in adolescents with asthma. Furthermore, because coping can mediate the effects of health stressors on QOL, this study also examined the indirect effect of asthma severity on QOL via coping. Between January and May 2003, 553 Dutch adolescents with asthma (aged 12–6 years) completed questionnaires assessing coping strategies, symptom severity, overall QOL and positive QOL domain (positive effects of asthma domain). The relations between symptom severity, coping strategies and QOL were tested with structural equation modelling (SEM). Symptom severity affected overall and positive QOL, both directly and indirectly via coping. The coping strategies restricted lifestyle and worrying about asthma were associated with poorer overall QOL. The use of the coping strategies restricted lifestyle, positive reappraisal, and information seeking was related to increased scores on the positive QOL domain, whereas hiding asthma was related to lower scores on the positive QOL domain. The findings of this study suggest that coping mediates the effect of symptoms of asthma on QOL among adolescents with asthma. Several suggestions for interventions to improve asthma-specific QOL are discussed.

Emotional, external and restrained eating behaviour and BMI trajectories in adolescence.

Individual differences in eating behaviours might partly explain the variations in development of weight gain and subsequent overweight and obesity. In the current study, identified trajectories of BMI in adolescence and their associations with restrained, emotional and external eating were tested. For the assessment of BMI trajectories growth mixture modelling was used; a method used to identify clusters of individuals within a population that follow distinct developmental trajectories. In total 328 Dutch adolescents (13-15years old at baseline) self-reported their height and weight at five annual waves and their eating behaviour at baseline. Development of BMI was best fitted in five distinct trajectories that showed similar moderate increase of BMI over time; parallel but at a different level. High restrained eaters had a higher chance of being in the higher BMI trajectories. Emotional and external eating were unrelated to the BMI trajectories. In conclusion, adolescents in this study followed very parallel patterns of moderate increases in BMI which suggests that factors acting on individual differences in weight status have had their influence mostly at a - perhaps much - younger age. Restraint eating was related to BMI in early adolescence, but not to an increases or decreases in BMI over the course of adolescence.

Factorial and Convergent Validity of Nicotine Dependence Measures in Adolescents: Toward a Multidimensional Approach

The present study investigated the possibility of forming a multidimensional scale for the measurement of nicotine dependence among adolescents, based on the modified Fagerström Tolerance Questionnaire (mFTQ) and the Hooked on Nicotine Checklist (HONC). A survey was conducted among 33 Dutch secondary schools, resulting in 2,041 smokers who completed the questionnaire. Motivation to quit and number of quit attempts were assessed and used as convergent construct variables for the construct of nicotine dependence. The findings show that combining the items of the mFTQ and the HONC results in three distinct dimensions: behavioral aspects of nicotine dependence, craving, and nervousness during abstinence. We examined this new multidimensional model in a second sample using confirmatory factor analysis. The new multidimensional measure fitted the data satisfactorily and showed good psychometric properties. Results of this study support the notion that nicotine dependence among adolescents is multidimensional.

School-based programmes to reduce and prevent substance use in different age groups: What works for whom? Systematic review and meta-regression analysis.

BACKGROUND Findings from systematic reviews and meta-analyses about the effectiveness of school-based programmes to prevent or reduce substance abuse are inconclusive. We hypothesise that in order to be effective, programmes have to be aligned with the developmental stages of the intended target group (childhood, early, middle, or late adolescence). The present study provides an overview of universal and targeted programmes, while distinguishing four age groups and examining which intervention characteristics are the effective components for the respective groups. METHODS Databases were searched for controlled studies of school-based programmes, evaluating their effectiveness on either smoking, alcohol or drug use. Multivariate meta-regression analysis was used to analyse the associations between effects and programme characteristics. RESULTS Our meta-analysis evaluates 288 programmes with a total of 436,180 participants. The findings support our hypothesis that specific aspects of the school-based programmes are effective in some developmental stages, but not for other age groups. The differences in effectiveness are systematically related to psychological and cognitive needs and capacities. DISCUSSION Our findings highlight the importance of considering a developmental perspective when designing and offering school-based prevention programmes. The various developmental stages offer different possibilities and opportunities for the reduction and prevention of substance use.