Background Parental smoking strongly influences adolescent smoking, yet few studies have examined factors that may protect against this. We investigated whether skills-based components of positive mental health (‘mental health competence’, MHC) modified the association between parental and teenager smoking, in the UK-representative Millennium Cohort Study (approximately 18 000 children, born 2000–02; analytic sample: n = 10 133). Methods Cohort members (CMs) reported at 14 years (y) whether they had ever smoked cigarettes. A dichotomized variable indicated whether one/both parents smoked when CMs were 11 y. A four-class latent MHC measure captured learning skills and prosocial behaviours at 11 y: High, High–Moderate, Moderate, Low. We examined effect measure modification (on the additive scale) by comparing risk differences (RDs) for CM smoking according to parental smoking, within each MHC class. We then estimated RDs for CM smoking according to combinations of parental smoking and MHC. Analyses accounted for confounding, sample design, attrition and item missingness. Results CMs were more likely to smoke cigarettes if their parent(s) smoked (27%) than CMs with no parent(s) who smoked (11%; RD: 16%). When stratified by MHC, RDs were stronger for low MHC (21%; 95% CI 11–31%) than other MHC classes (ranging: 7–11%). Compared to CMs with high MHC and non-smoker parents, those with low MHC and parent(s) who smoked had an RD of 28% (95% CI 20–36%). This was greater than the sum of RDs for those with low MHC and non-smoker parent(s) [7% (2–14%)] plus those with high MHC and whose parent(s) smoked [11% (7–15%)]. There was limited effect measure modification by moderate or High–Moderate MHC. Conclusion Improving MHC to moderate levels may help reduce intergenerational transference of smoking.

中文翻译：

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心理健康能力能否降低父母吸烟的青少年开始吸烟的较高风险？

背景 父母吸烟对青少年吸烟的影响很大，但很少有研究检查可能防止这种情况发生的因素。我们在具有英国代表性的千年队列研究（约 18000 名儿童，2000-02 年出生；分析样本）中调查了积极心理健康的基于技能的成分（“心理健康能力”，MHC）是否改变了父母和青少年吸烟之间的关联。 : n = 10 133)。方法 队列成员 (CM) 在 14 岁 (y) 时报告他们是否曾经吸烟。一个二分变量表示当 CM 为 11 岁时父母一方/双方是否吸烟。一项四级潜在 MHC 测量捕获了 11 岁时的学习技能和亲社会行为：高、高-中、中、低。我们通过在每个 MHC 类别中根据父母吸烟比较 CM 吸烟的风险差异 (RD) 来检查效果测量修改（在加性量表上）。然后，我们根据父母吸烟和 MHC 的组合估计了 CM 吸烟的 RD。分析解释了混杂因素、样本设计、损耗和项目缺失。结果 如果父母吸烟（27%）的 CM 比没有父母吸烟的 CM（11%；RD：16%）更有可能吸烟。当按 MHC 分层时，低 MHC 的 RD（21%；95% CI 11-31%）比其他 MHC 类别（范围：7-11%）更强。与具有高 MHC 和不吸烟父母的 CM 相比，那些具有低 MHC 和吸烟的父母的 RD 为 28% (95% CI 20–36%)。这大于 MHC 低且父母不吸烟者 [7% (2-14%)] 加上 MHC 高且父母吸烟者 [11% (7-15 %)]。中度或高-中度 MHC 对效果测量的修改有限。结论 将 MHC 提高到中等水平可能有助于减少吸烟的代际传递。