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Int. J. Environ. Res. Public Health 2016, 13(1), 74; doi:10.3390/ijerph13010074

Transmission of Smoking across Three Generations in Finland

School of Health Sciences, University of Tampere, 33014 Tampere, Finland
Tobacco, Gambling and Addiction Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland
Science Centre, Pirkanmaa Hospital District, 33521 Tampere, Finland
National School of Public Health, Lisbon NOVA University, P-1600-560 Lisbon, Portugal
PERLA—Tampere Centre for Childhood, Youth and Family Research, University of Tampere, 33104 Tampere, Finland
Department of Adolescent Psychiatry, Pitkäniemi Hospital, Tampere University Hospital, 33380 Nokia, Finland
Author to whom correspondence should be addressed.
Academic Editor: Zubair Kabir
Received: 22 October 2015 / Revised: 17 December 2015 / Accepted: 21 December 2015 / Published: 24 December 2015
View Full-Text   |   Download PDF [377 KB, uploaded 24 December 2015]   |  


The influence of parents’ smoking on children’s smoking is well known, but few studies have examined the association between grandparents’ and grandchildren’s smoking. We studied the association between paternal and maternal grandparents’ smoking and their grandchildren’s tobacco use and assessed whether parents’ smoking is a mediator in this process. Data were obtained from a national survey of 12–18-year-old Finns in 2013 (N = 3535, response rate 38%). Logistic regression and mediation analyses were used. Both boys and girls had higher odds for smoking experimentation, daily smoking and other tobacco or tobacco-like product use if their mother, father or any of the four grandparents were current or former smokers. When parents’ and grandparents’ smoking status were included in the same model, grandparents’ smoking generally lost statistical significance. In the mediation analysis, 73% of the total effect of grandparents’ smoking on grandchildren’s daily smoking was mediated through parents’ smoking, 64% on smoking experimentation and 63% on other tobacco or tobacco-like product use. The indirect effect of a mother’s smoking was higher than that of a father’s. To conclude, paternal and maternal grandparents’ smoking increases grandchildren’s tobacco use. The influence is mainly, but not completely, mediated through parents’ smoking. View Full-Text
Keywords: smoking; tobacco use; adolescents; intergenerational transmission; parents; grandparents smoking; tobacco use; adolescents; intergenerational transmission; parents; grandparents

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

El-Amin, S.E.T.; Kinnunen, J.M.; Ollila, H.; Helminen, M.; Alves, J.; Lindfors, P.; Rimpelä, A.H. Transmission of Smoking across Three Generations in Finland. Int. J. Environ. Res. Public Health 2016, 13, 74.

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