• tobacco smoking;
  • adolescence;
  • parent attachment


Aims: To assess whether low attachment to parents is a consistent risk factor for adolescent smoking or is modified by ethnicity and parental smoking.

Methods: A national, cross-sectional multi-ethnic 2005 survey of 28,395 Year 10 students aged 14 and 15 years (18,934 Europeans, 4,769 Maori, 2,795 Asians, 1,897 Pacific Islanders). Students answered an anonymous questionnaire including measures of attachment to parents from the Inventory of Parent and Peer Attachment.

Results: The prevalence of adolescent smoking > monthly, going from the lowest to the highest quartile of parent attachment score, was 28%, 16%, 12% and 10%. The relative risk of smoking ≥ monthly for students in parent attachment quartile 1, compared to quartile 4, was increased in all ethnic groups, being 4.37 (95% confidence interval 3.00, 6.38) in Asian, 3.12 (2.77, 3.51) in European, 1.97 (1.45, 2.67) in Pacific Island, and 1.36 (1.23, 1.51) in Maori students, adjusting for sex and school socioeconomic decile. The ethnic variation in relative risk was explained mostly by a variable smoking prevalence in the reference category (quartile 4) which ranged from 3% in Asian students to 29% in Maori. A similar pattern was seen when students were categorised by parental smoking, with students in the lowest parent attachment quartile having a significantly (p<0.05) raised relative risk of smoking ≥ monthly compared to the highest quartile, regardless of whether their parents smoked or not.

Conclusions & Implications: Low parent attachment score is associated with an increased risk of adolescent smoking regardless of ethnicity and parental smoking.