• Kwok-Kei Mak, Sai-Yin Ho, and Jeffrey R Day.
• School of Public Health, Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
• Nicotine Tob. Res. 2012 Sep 1;14(9):1057-64.

IntroductionThis study investigates the independent and combined effects of smoking of parents and best friend on smoking and the intention to initiate or quit smoking in adolescents.MethodsIn this school-based survey, 6,553 Hong Kong students aged 13-18 reported their demographic characteristics, smoking status of themselves, parents, and best friend; and intention to smoke (initiation among never-smokers and reinitiation among ex-smokers) or quit smoking among current smokers. Logistic regression yielded adjusted odds ratios (AORs) of student smoking (current/ever) and intention to smoke or quit smoking for parental (paternal/maternal/both parents vs. none) and best friend (yes vs. no) smoking.ResultsParental smoking and having a smoking best friend were associated with adolescent current smoking, ever smoking, and intention to initiate smoking. Having a smoking best friend was also associated with reinitiating and quitting smoking. The AORs (95% CI) of current smoking for having a smoking best friend, in addition to smoking father, mother, or both were 19.14 (14.36-25.51), 20.38 (12.42-33.43), and 24.18 (15.89-36.77). The respective AORs of ever smoking were 8.30 (6.74-10.22), 8.92 (5.63-14.12), and 11.99 (8.05-17.87).ConclusionsParental smoking and best friend smoking have independent effects on adolescent smoking behaviors. Their combined effects on current and ever smoking were particularly large. Smoking prevention programs should pay special attention to adolescents with both best friend and parents who smoke.

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