Parental Smoking and Adult Offspring’s Smoking Behaviors in Ethnic Minority Groups: An Intergenerational Analysis in the HELIUS Study

Abstract Introduction To understand smoking behaviors among ethnic minority groups, studies have largely focused on societal factors, with little attention to family influences. Yet studies among majority groups have identified parental smoking as an important risk factor. It is unknown whether this applies to ethnic minority groups. We investigated the association between parental smoking and adult offspring’s smoking behaviors among ethnic minority groups with an immigrant background. Methods We used data from the Healthy Life in an Urban Setting study from Amsterdam (the Netherlands) from January 2011 to December 2015. The sample consisted of 2184 parent-offspring pairs from South-Asian Surinamese, African Surinamese, Turkish, Moroccan, and Ghanaian origin. We collected self-reported smoking data: current status, duration of exposure to parental smoking, number of daily cigarettes, heavy smoking ( > 10 cigarettes/day), and nicotine dependency (using the Fagerström Test). Analyses were stratified by offspring’s age, cohabitation with parent, education (parent/offspring), offspring’s cultural orientation, and gender concordance within pairs. Logistic regression was used. Results Overall, parental smoking was associated with offspring’s smoking behaviors (eg, current smoking: odds ratio 2.33; 95% confidence interval 1.79–3.03), with little ethnic variation. We found dose-response associations between exposure to parental smoking and offspring’s smoking. The associations were similar across different strata but stronger in gender-concordant pairs (3.16; 2.12–4.51 vs. 1.73; 1.15–2.59 in gender-discordant pairs; p-value for interaction .017). Conclusions Parental smoking is associated with offspring’s smoking behaviors in ethnic minority groups across different strata but particularly in gender-concordant pairs. Similar to majority groups, family influences matter to smoking behaviors in ethnic minority groups. Implications Our findings have deepened our understanding of smoking behaviors among ethnic minority groups. Future studies should simultaneously consider societal factors and parental influences, to comprehensively understand their impact on smoking among ethnic minority groups. Also, smoking patterns among family members should be addressed in individual counselling, irrespective of ethnicity.