Links between Parent Conventional Cigarette and e-Cigarette Use and Child Use of Conventional Cigarettes, e-Cigarettes, Marijuana, and Alcohol

Introduction: The literature on tobacco use has shown that parental smoking is one of the strongest predictors of child cigarette use, and also has linked parental smoking to child use of other substances, including alcohol and marijuana. Based on this prior literature and theories focused on parental modeling and social norms, parent use of e-cigarettes also should predict child use of e-cigarettes, as well as conventional cigarettes, alcohol, and marijuana. However, since many adults who use e-cigarettes are already current or former smokers, it is unclear whether e-cigarette use poses additional risk for child substance use.

Methods: Data were drawn from the SSDP Intergenerational Project (SSDP-TIP, N = 423 families), a longitudinal study that began in 2002 with the goal of investigating the intergenerational transmission of substance use and other behaviors. In 2015 and 2016, parents and children reported on their e-cigarette and conventional cigarette use; children also reported on their use of alcohol and marijuana. Analyses examined associations between parental e-cigarette and cigarette use (0 no use, 1 e-cigs only, 2 conventional cigs only, 3 dual use) and child use of e-cigarettes, conventional cigarettes, alcohol, and marijuana. Additional planned analyses will incorporate data from 2017, and use multilevel modeling to analyze repeated measures of child substance use outcomes.

Results: Rates of lifetime e-cigarette use were similar among parents and youth (~24%). Few parents and children were e-cigarette only users (7% and 11%, respectively). Of the parents who used e-cigarettes, 71% had also used conventional cigarettes in the past year, whereas 53% of the children who used e-cigarettes reported past year cigarette use. In preliminary analyses, parental use of conventional cigarettes, either alone (conventional cigs only) or with e-cigarettes (dual use) predicted higher rates of child e-cigarette, conventional cigarette, and marijuana use, but not alcohol use.

Conclusions: Most youth who used e-cigarettes were not recent conventional cigarette users, which is in line with prior research suggesting that e-cigarettes may be attracting non-smoking youth. Results suggest that parental use of conventional cigarettes poses a risk for child nicotine and other substance use; the additional consideration of parental e-cigarette use did not appear to add to the risk posed by parental conventional cigarette use. Continued efforts to reduce conventional cigarette use among parents and to prevent youth use of e-cigarettes are clearly needed. Additional research is needed to more thoroughly explore the relative contributions of parental e-cigarette and conventional cigarette use to child substance use.