Parental, Peer, and Tobacco Marketing Influences on Adolescent Smoking in South Africa

Tobacco use is a major preventable cause of morbidity and mortality worldwide. Most smokers initiate smoking in childhood, become addicted, and continue the habit into adulthood. Various factors have been shown to impact smoking behavior. It is important to determine how these factors impact smoking behavior in developing regions of the world, such as in South Africa. This study examines the association between parental smoking status; peer smoking status; exposure to pro-tobacco marketing; and current smoking status among adolescents in South Africa. It also determines which factor is the most significant predictor of current smoking status among the study population and further examines the trends in these factors among survey populations from 1999 – 2008. Secondary analysis was conducted on data obtained from the Global Youth Tobacco Survey. Logistic regression analyses were conducted to determine the association between the independent variables; parental smoking status, peer smoking status, and exposure to pro-tobacco marketing; and the dependent variable, current smoking status, controlling for other factors. Adolescents who had at least a parent or a friend who smoked had greater odds of being current smokers as compared to those who had neither a parent nor a friend who smoked. Similarly, exposure to average and high levels of pro-tobacco marketing was associated with greater odds of an adolescent being a current smoker as compared to exposure to low levels of pro-tobacco marketing. Maternal smoking appeared to have a greater impact on adolescent smoking behavior as compared to paternal smoking. Also, peer smoking had the greatest impact on smoking behavior as compared to the other independent factors. Smoking rates among South African adolescents has decreased from 23% in 1999 to about 17% in 2008. Similarly, the proportion of adolescents who had a parent or a friend who smoked, or had been exposed to average and high levels of pro-tobacco marketing has also decreased over the same period. Programs must be implemented to educate parents on how their smoking behavior is being transmitted to their children, with a special focus on maternal influences. Tobacco use prevention campaigns aimed at the youth should also be implemented, and laws restricting tobacco marketing must be enforced