摘要：Objectives. We investigated the relationship among father’s occupational group, daily smoking, and smoking determinants in a cohort of New Zealand adolescents. Methods. The longitudinal Multidisciplinary Health and Development Study provided information on adolescents’ self-reported smoking behavior and potential predictors of smoking, such as social and material factors, personality characteristics, educational achievement, and individual attitudes and beliefs regarding smoking. Longitudinal logistic generalized estimating equation analyses were used. Results. Adolescents whose fathers were classified in the lowest-status occupational group were twice as likely as those whose fathers occupied the highest-status occupational group to be daily smokers. This high risk of daily smoking among the adolescents from the lowest occupational group was largely predicted by their lower intelligence scores and by the higher prevalence of smoking among fathers and friends . Conclusions. To prevent socioeconomic differences in smoking, school-based interventions should seek to prevent smoking uptake among adolescents, particularly those of lower socioeconomic status. Programs need to provide positive, nonsmoking role models consonant with the culture and norms of lower-socioeconomic-status groups. Adolescents need to acquire resistance skills and protective behaviors against social pressure and influences. Attempts to describe and explain socioeconomic differences in unhealthy behavior have mainly focused on adults. But lifestyle patterns observed among adults are largely developed during adolescence and are perpetuated into adulthood. Little is known about the emergence of socioeconomic differences in unhealthy lifestyles during adolescence and even less about the determinants of this process. Such information would greatly facilitate the design of effective interventions to prevent the development of socioeconomic differences in behavior at an early stage. The objective of our study was to examine patterns and predictors of socioeconomic differences in adolescent smoking behavior. The longitudinal Dunedin Multidisciplinary Health and Development Study followed a birth cohort of approximately 1000 individuals during their entire adolescence and thus provides a unique opportunity to describe and explain the relationship between father’s occupational group and adolescents’ daily smoking. This article is among the first to report on the contribution by a variety of determinants of adolescent smoking to the association between father’s occupational group and daily smoking among adolescents. A review of the literature shows that adolescents of lower socioeconomic status (SES) smoke more often than do their peers of higher SES, 1– 13 though some studies fail to find such a relationship. 14– 16 This hypothetical relationship between parental SES and adolescent smoking might originate from a higher prevalence of determinants of adolescent smoking among lower-SES groups. To date, not many predictors of adolescent smoking behavior have been investigated regarding their association with SES, and only 2 other studies have analyzed the contribution of such predictors to socioeconomic differences in smoking behavior. 4, 12 The adolescent smoking literature emphasizes the effect of modeling behavior of parents and peers. Children who have smoking parents (or who live with people who smoke) 4, 5, 8, 10, 12, 14, 15, 17– 27 or who have friends who smoke 1, 2, 6, 8, 12, 18– 24, 28 are more inclined to start smoking during adolescence, though some studies have not found such a relationship. 6, 7, 28, 29 Other social factors that are reported to predict smoking during adolescence are perceived approval or pressure to smoke, 2, 7, 18, 22, 27, 30– 32 poor family support or control, 6, 12, 14, 22, 24, 26, 33 poor social bonding, 2 and high involvement in social activities. 30 Seltzer and Oechsli 9 addressed the predictive potential of personality traits with regard to adolescent smoking and reported that children with type-A personality traits, extraversion, and psychoticism are more likely to begin smoking during adolescence than are children without these characteristics. (A person that scores high on psychoticism will exhibit some qualities commonly found among psychotic persons. Examples of psychotic tendencies include recklessness, disregard for common sense, and inappropriate emotional expression.) External locus of control, 11, 18, 34 low self-esteem, 1, 2, 11, 22, 23, 26, 35 and deviant or risky behavior 2, 18, 22, 23, 25, 26, 35 are also related to adolescent smoking. Individual positive attitudes and beliefs related to smoking 2, 6, 17, 18, 27, 28, 30, 36 predict adolescent smoking, though McNeill et al 7 found no such a relationship. Educational achievement also plays a role in adolescent smoking. Poorer school achievement, 4, 19, 23 negative attitudes toward or poor adjustment in school, 17, 22 low academic expectations, 2, 17, 18, 24, 26 and average or below-average school performance 1, 17, 20, 22, 25 all predict smoking during adolescence. (Murray and colleagues, 30 however, found no relationship between attitude toward school or truancy and smoking during adolescence.) In general, material factors are considered important determinants of socioeconomic differences in health or health-related behavior. 37– 39 Smoking behavior during adolescence is predicted by the availability of money. 2, 7 Although the relationship between predictors of adolescents’ smoking behavior and SES has not been the subject of many studies, some of the above-mentioned predictors are reported to be more prevalent in lower SES groups. Adolescents of lower SES are more likely than those of higher SES to have smoking parents, friends, peers, and siblings 10, 12, 23 ; they also experience more social pressure to smoke and positive norms involving smoking, 10 and they more often report an external locus of control, 11– 12 lower self-esteem, 12 and poorer academic achievement. 12 We hypothesized that these determinants contribute to socioeconomic differences in adolescent smoking.
