Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1339-1347 (doi:10.1542/peds.2005-1881)
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Cigarette Smoking in the Adolescent Children of Drug-Abusing Fathers

David W. Brook, MD, Judith S. Brook, EdD, Elizabeth Rubenstone, BA, Chenshu Zhang, PhD and Connie Gerochi, BA

Department of Psychiatry, New York University School of Medicine, New York, New York

OBJECTIVE. This study examined the longitudinal predictors of cigarette smoking in a sample of at-risk adolescents whose fathers were drug abusers (N = 296).

METHODS. At time 1, structured interviews were administered, separately and in private, to male and female youth (X age = 16.3) and their fathers; adolescents were reinterviewed ~1 year later (at time 2). Structural equation modeling was used to examine the interrelationship of time 1 paternal tobacco and illicit drug use, father–child relations, adolescent psychological adjustment, and peer group factors and adolescent smoking at time 2. A supplementary analysis assessed the same model with control on the adolescent's age, gender, frequency of contact with the father, and the father's treatment status.

RESULTS. The structural equation model showed a mediational pathway linking paternal tobacco and drug use to a weak and conflictual father–child relationship, which was associated with greater adolescent maladjustment, which in turn was related to deviant peer affiliations, which predicted adolescent smoking at time 2. There was also a direct path from paternal tobacco and drug use to adolescent time 2 smoking. The supplementary analysis found no significant differences between the models with and without control.

CONCLUSIONS. Findings provide evidence of the mechanisms that underlie the association between paternal drug use characteristics and smoking in the adolescent child. Clinical implications suggest the importance of the father–child relationship to smoking prevention programs for at-risk youth.

Key Words: paternal drug use • at-risk youth • adolescent smoking • father-child relationship

Abbreviations: SEM—structural equation model • GFI—goodness-of-fit index

Accepted Sep 30, 2005.