Elsevier

Public Health

Volume 164, November 2018, Pages 115-117
Public Health

Short Communication
Perceived parental reactions to substance use among adolescent vapers compared with tobacco smokers and non-users in Iceland

https://doi.org/10.1016/j.puhe.2018.08.005Get rights and content

Highlights

  • A total of 13.6% of study participants were current vapers and non-smokers.

  • Electronic cigarette (EC)-only users were more likely than non-smokers to have tried other substances.

  • Perceived parental reaction to substance use was highest for non-users.

  • Perceived parental reaction to substance use was lower for vapers than non-users.

  • Perceived parental reaction to substance use was lower for smokers than vapers.

Abstract

Objectives

The objective is to assess perceived parental reactions to cigarette smoking, vaping, drunkenness, and marijuana use among cigarette smokers, vapers, and those who neither smoke nor vape (non-users).

Study design

It is a population-based, cross-sectional, school survey with all accessible 13- to 16-year-old students in Iceland (response rate: 84.1%).

Methods

Data were analyzed in Mplus using multinomial logistic regression for categorical data with maximum likelihood and robust standard errors, adjusting for potential school clustering.

Results

Across all four outcome categories and controlling for background factors, non-users were more likely than vapers and smokers to perceive their parental reactions to substance use as negative (P < 0.01). Vapers were significantly more likely than smokers to perceive their parental reactions as negative toward all types of substance use (P < 0.01).

Conclusions

Adolescent smokers, vapers, and non-users appear to form a sequential risk gradient toward perceived parental reactions to substance use, with smokers being least likely to perceive their parental reactions as negative and vapers thereafter; non-users are most likely to perceive their parental reactions toward substance use as negative.

Introduction

While the long-term physical harm of vaping remains unclear, it is generally considered a safer alternative to tobacco smoking,1 although vaping, especially for minors, is not entirely harmless.2 The tobacco control community has also highlighted notable differences in viewpoints on vaping based on the principles of primary prevention (i.e., prevention of initiation) and secondary prevention (i.e., smoking cessation, harm reduction).3, 4 However, irrespective of different viewpoints about the physical harm of vaping and whether electronic cigarettes are applicable as harm reduction tools for current smokers, a more consistent literature has now established that adolescents who initiate vaping before any form of tobacco use are significantly more likely than never users to escalate into smoking.5 Vaping should, therefore, be discouraged among never smokers.

From a primary prevention perspective, an important effort to curb the initiation of vaping by never smokers is to understand the level of environmental sanctions, or lack thereof, that contribute to the odds of vaping and other substance use. Few sanctions are more important than the ones provided by parents.6, 7 Parents are at the center of most primary prevention efforts and programs,6 and their perceived disapproval of usage by children and adolescents is an important preventive mechanism.7 In this study, we investigated the relationship among perceived parental reactions to vaping, smoking, drunkenness, and marijuana use in a large sample of 13- to 16-year-old never smokers, vapers, and cigarette smokers, in Iceland, which has been highlighted for its strong community-based primary prevention efforts that have led in achieving some of the greatest reductions in adolescent substance use in all of Europe over a 20-year period.8 Iceland, currently, has the lowest or the second lowest rates of adolescent smoking and alcohol use in all of Europe.8

Section snippets

Methods

Data from the 2018 population-based Youth in Iceland survey on substance use and risk, and protective factors were analyzed. The survey was administered to all 8th through to 10th grade students (aged 13–16 years) in Iceland, by the Icelandic Centre for Social Research and Analysis at Reykjavik University. Consistent with published protocols,9 data collection was conducted at the population level with all accessible students in all 135 schools in the country, using anonymous questionnaires,

Results

About 83% of the sample had neither tried vaping nor tobacco smoking, 3.2% were current smokers, and 13.6% were current vapers. Table 1 shows the results from the multinomial logistic regression models with vapers as a reference group. After controlling for confounding background variables, i.e. gender, grade, family structure, family financial status, and parental education, non-users were significantly more likely than vapers to report that their parents would react negatively to all four

Discussion

These results indicate that even after controlling for a host of background variables, non-users were more likely to perceive their parental reactions to all forms of substance use as negative, compared with vapers, who subsequently were more likely than smokers to perceive their parental reactions as negative to all forms of substance use. These findings suggest a sequential risk gradient by the smoking status in perception to parental reactions to substance use. Previously, we found a similar

Ethical approval

Data collection procedures for this study were deemed ‘exempt’ by the National Bioethics Committee of Iceland that oversees the ethical review of studies with human subjects (Ref # VSNb2017020009/04.01).

Funding

No specific funding was provided for this analysis.

Competing interests

All authors declare no competing interests.

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