Common and unique parenting predictors of adolescent tobacco and alcohol use

Aim

The current study sought to identify unique and common demographic and parental predictors of adolescent tobacco and alcohol initiation behaviors.

Methods

A total of 1023 middle school students (Grades 6–8) and their parents from six Rhode Island schools were enrolled in a larger study on substance use initiation and progression, with the current sample representing those dyads with data at baseline and at a 12-month follow-up (n = 814 dyads). There was a relatively even split with regard to adolescent sex (n_females = 444; 55%). Comparisons were made between covariate and predictor associations with corresponding substance use behaviors (e.g., ever puffed a cigarette vs. ever sipped an alcoholic drink; ever smoked a whole cigarette vs. ever drank a full alcoholic drink).

Results

At the bivariate level, a host of demographic and parent-related variables were associated with each adolescent substance use behavior. Adolescent reports of parental monitoring variables were consistently more related to use than parent reports. In multivariate logistic regression analyses, adolescent reports of parental monitoring variables were more frequently associated with tobacco use behaviors than alcohol use behaviors. Tobacco use behaviors were more strongly predicted by perceived availability of tobacco than alcohol use behaviors were predicted by perceived availability of alcohol.

Conclusions

The distinctive predictors observed for cigarette versus alcohol use make it problematic for new and existing programs to assume that efforts targeting specific individual or parental characteristics will impact both substances with equivalent efficacy.     

Perceived parental reactions and peer respect as predictors of adolescent cigarette smoking and alcohol use

Cigarette smoking and alcohol use contribute substantially to the global burden of morbidity and premature mortality. Most use begins during adolescence, often with experimentation taking place between 11 and 15 years of age. This study examined the importance of perceived parental reactions to, and peer respect for, cigarette smoking and alcohol use. Particular attention was given to the relative importance of these variables compared with the more widely examined influences of perceived parental and peer support. Our final models explained 44% of the variance in cigarette smoking and 46% in alcohol use. Most of the explained variance in both cigarette smoking and alcohol use was accounted for by only three variables: peer use, perceived parental reaction to use, and perceived respect from peers if using. Our findings indicate that perceived parental reaction to use and peer respect for use may be important contributors to adolescent cigarette smoking and alcohol use.     

Patterns of substance use among Argentinean adolescents and analysis of the effect of age at first alcohol use on substance use behaviors

Objective

The present study used an empirically based method to characterize substance use in a sample of Argentinean adolescents and analyzed the association between age at drinking onset and substance use behaviors. Differences in alcohol expectancies and personality traits as a function of different patterns of substance use were also explored.

Method

Data were obtained from 583 adolescents aged 13–18 years (M = 15.01 years; SD = 1.5 years; 59.5% female) from the city of Cordoba, Argentina. Alcohol, tobacco, and drug use and age at first alcohol use were measured. Personality traits, including extroversion, conscientiousness, impulsivity, and aggression, and positive and negative alcohol expectancies were assessed. Latent Class Analysis was applied to examine the structure of five co-occurring substance use behaviors: frequency of alcohol use, quantity of alcohol use, prevalence of drunkenness episodes, tobacco use, and drug use.

Results

Latent Class Analysis revealed five distinct patterns of substance use. The classes differed in substance use behaviors, personality traits, and alcohol expectancies. Adolescents with early drinking onset were more likely to show heavier alcohol use, more drunkenness episodes, and more drug use than adolescents with late drinking onset.

Conclusions

Latent Class Analysis allowed the detection of groups of adolescents with distinct patterns of substance use. These groups exhibited significantly different personality and alcohol expectancy profiles, likely representing subgroups who are at greater risk for developing alcohol-related problems.     

Alcohol problems as a signal for sensitivity to nicotine dependence and future smoking

Background

Alcohol use is a well-documented risk factor for the emergence of chronic smoking behavior. Very little is known, however, about the mediating pathways through which alcohol and/or alcohol-related problems influence future smoking.

Methods

Data were drawn from the longitudinal Social and Emotional Contexts of Adolescent Smoking Patterns Study (SECASPS). Adolescents who had smoked under 100 cigarettes in their lifetime (n = 898; experimenters) and adolescents who had smoked over 100 cigarettes, but fewer than 5 cigarettes per day (n = 152: current smokers) were examined separately (grouping variable). Path analysis was performed to investigate the association between alcohol related problems at baseline (primary predictor) and smoking regularity at the 48 month follow-up (primary outcome), both directly and through mediating variables of smoking quantity and frequency, and nicotine dependence (averaged across these measures at 6-, 15-, and 24-month assessment waves).

Results

Among experimenters, after controlling for smoking and alcohol use, the association between alcohol-related problems at baseline and smoking frequency 48 months later was fully mediated by nicotine dependence symptoms. Among current smokers, only past smoking behavior was associated with 48-month smoking frequency.

Conclusions

Alcohol-related problems are a risk factor for future smoking among novice adolescent smokers above and beyond drinking or smoking per se. By signaling sensitivity to nicotine dependence symptoms, alcohol related problems represent an easily measureable risk factor that can be used to identify and intervene with adolescents before more chronic smoking behaviors emerge.     

Sex specific trajectories in cigarette smoking behaviors among students participating in the unplugged school-based randomized control trial for substance use prevention

Objectives

Understanding the developmental pathways and sex differences in cigarette smoking behaviors in adolescents has the potential to positively impact substance abuse prevention and to reduce smoking-related health problems. Using data from the Unplugged school-based prevention trial, we investigated different patterns of smoking behavior development among secondary school students in the Czech Republic.

Methods

Growth mixture modeling was used to examine different trajectories in cigarette smoking behaviors among male and female students (N = 1874 6th graders; 50.4% male, mean age 11.8 years at baseline) participating in the Unplugged school-based randomized control trial for substance use prevention.

Results

A two-class model characterized cigarette use as a function of sex and Unplugged intervention status. More rapid cigarette use increases were observed in females (OR = 1.17, p = 0.01 in both rapid/moderate and slow smoking escalator classes) as compared to males. Further, in both classes, more rapid increases in smoking were observed for the control group as compared to the intervention group (OR = 1.22, p < 0.01 slow escalators; OR = 1.54, p = 0.08 rapid/moderate escalators). There was no difference in sex distribution when comparing the two classes (OR = 1.02, p = 0.98).

Conclusions

This study adds to a growing literature on developmental and sex differences in cigarette use among adolescents. This research supports additional multi-year prevention strategies aimed at adolescent females and early treatment programs for adolescent smokers to prevent increasing cigarette use with age.     

Impact of social influences and problem behavior on alcohol use among inner-city Hispanic and black adolescents.

OBJECTIVE: Inner-city black and Hispanic adolescents might be at great risk for alcohol use. Yet the etiology of drinking among these adolescents receives little attention. The purpose of this study was to examine the impact of social influences and problem behavior on alcohol use among Hispanic and black adolescents. The impact of these factors was also tested separately for girls and boys to determine the differences in etiology of alcohol use depending on gender. METHOD: A large sample of black and Hispanic seventh-grade students (N = 4,847, 52% female) self-reported alcohol use, demographic characteristics (gender, family structure, age, ethnicity and socioeconomic status), social influences to drink (peer norms, adult norms, their friends' use, their mother's use, their father's use, their siblings' use, and perceived availability of alcohol), and problem behaviors (cigarette smoking, marijuana use, getting into trouble). Teams of three to five data collectors administered the questionnaire following standardized protocol. These data were collected in class during a regular 40-minute period. RESULTS: Logistic regressions indicated that social influences to drink from friends, peers, and family and problem behaviors including cigarette smoking and marijuana use were related to alcohol use across and within gender. Getting into trouble predicted drinking for boys but not girls. CONCLUSIONS: Based on these findings, adolescent alcohol prevention programs need to include an awareness of the many social influences to drink, modify incorrectly perceived peer norms for drinking, involve family members in the prevention program and address an array of problem behaviors within one prevention intervention.     

Types of polydrug use among Spanish adolescents

Objective

This study examined the types of polydrug use among Spanish adolescents.

Method

1501 high school students (50.6% female) aged 12 to 17 years old (mean age = 14.03, SD = 1.28), from public schools in the city of Girona (Catalonia, Spain), completed the survey.

Results

In the previous six months 20.9% of the Spanish adolescents used alcohol, 18.8% tobacco, 10.5% cannabis and 0.7% cocaine. Specifically, 28.6% of the sample (n = 429; 29% males and 28.2% females) used at least one drug and 13.9% reported polydrug use (n = 208; 12.6% males and 15.1% females). The present research also found that the most critical ages for starting polydrug use were 14 and 15 years old. More than one quarter (27.9%) of the adolescent polydrug users were type A (tobacco and alcohol), 67.8% were type B (cannabis together with tobacco and/or alcohol) and 3.4% were type C (cannabis together with tobacco and/or alcohol, and cocaine).

Conclusions

These results suggest that Spanish adolescents, particularly males, commence polydrug use at an earlier age than other European adolescents. Early preventative strategies and a multisubstance perspective are greatly needed in Spain to avoid the initiation of polydrug use or to prevent progress onto heavier drugs.     

Familial and "on-the-street" risk factors associated with alcohol use among homeless and runaway adolescents

OBJECTIVE: This study investigated factors associated with alcohol use among homeless and runaway adolescents, using a risk-amplification model. METHOD: Homeless and runaway adolescents (N = 536, 60% female) were recruited and interviewed by outreach workers directly on the streets, in shelters and in drop-in centers in four Midwestern states. The average age was 16 years; ages ranged from 12 to 22. RESULTS: Parent alcohol problems were indirectly linked to adolescent drinking through familial abuse and its relationship to deviant peers, time on own and risky subsistence behaviors. Parent alcohol problems also predicted offspring alcohol use through parental rejection and its association with deviant peers and with risky subsistence behaviors. The strongest direct effects on alcohol use were hanging out with antisocial friends and participating in deviant behaviors in order to survive on the street. CONCLUSIONS: This study sheds light on the nature of alcohol use in a high-risk population. Family background and "on-the-street" (time on own) factors must be taken into consideration when treating alcohol misuse in street youth. The alternative is a vicious cycle whereby homeless youth may become homeless adults.     

Experimenting and daily smokers: Episodic patterns of alcohol and cigarette use

Alcohol use may facilitate the development of nicotine dependence. Alcohol is often paired with cigarette smoking, particularly in those experimenting with smoking. However, little research has examined episodic patterns of alcohol and cigarette use. This study examined patterns of alcohol and cigarette use in a college-aged sample (n = 237) designated as experimenters or smokers based on their smoking history. Participants reported their consumption of drinks and cigarettes by hour, for each hour, of a typical drinking and smoking episode. Self-reported pleasure and desire associated with smoking generally and while drinking was assessed. No group difference was observed in total number of drinks. However, experimenters delayed smoking until more drinks were consumed, suggesting they smoked after reaching binge levels of alcohol. By contrast, smokers smoked after fewer drinks. Both groups reported increased smoking while drinking and increased pleasure and desire when smoking while drinking. The increase was greater in experimenters. Concurrent alcohol and cigarette use may facilitate the development of tobacco dependence and interventions interrupting their pairing might impede the transition from experimenter to smoker.     

Family income trajectory during childhood is associated with adolescent cigarette smoking and alcohol use

Background

Although childhood socioeconomic disadvantage has been linked with adolescent tobacco and alcohol use in cross-sectional research, less is known about the influence of changes in socioeconomic status during childhood. Upward socioeconomic mobility may attenuate the negative influence of earlier socioeconomic disadvantage on health, while downward mobility may counter the health benefits of earlier socioeconomic advantage. This study evaluated the influence of common trajectories of family income during childhood on smoking and alcohol use during adolescence.

Methods

Data utilized were part of the 15-year longitudinal Study of Early Child Care and Youth Development. A 5-class trajectory model (two stable, one downward, and two upward income trajectories) was developed previously with this sample (N = 1356). Logistic regression analyses were conducted to determine whether children of the more disadvantaged income trajectories were more likely to engage in tobacco and alcohol use at age 15 relative to those of the most advantaged trajectory.

Results

Family income trajectory was significantly associated with ever-smoking (p = .02) and past-year alcohol use at age 15 years (p = .008). Children from the less advantaged trajectories were more likely to have ever-smoked than children of the most advantaged trajectory (all p's < .05). Children of the downwardly mobile trajectory were more likely to have used alcohol within the past year than children of the most advantaged trajectories as well as the most disadvantaged trajectory (all p's < .05).

Conclusions

Findings indicate that childhood socioeconomic disadvantage influences adolescent smoking, while downward socioeconomic mobility influences adolescent alcohol use.     

The use of the Risky Sex Scale among adolescents receiving treatment services for substance use problems: Factor structure and predictive validity

This study evaluated the use of the Risky Sex Scale (RSS; T. O'Hare, 2001) among youth in outpatient treatment for substance use problems. An ethnically diverse sample of 394 adolescents (280 males; M(age) = 16.33 years, SD(age) = 1.15) was recruited from 2 treatment sites. The study was guided by two aims. First, a confirmatory factor analysis was conducted on RSS item responses. Findings replicated the factor structure identified in previous studies of undergraduate students cited for campus alcohol violations. Second, structural equation modeling was used to document associations between RSS subscales and self-reported substance use and sexual risk behaviors. The risky sex expectancies subscale was significantly associated with co-occurring alcohol use and sex, alcohol use at last intercourse, and alcohol use during the prior 30 days. The risky sexual behaviors subscale was significantly associated with co-occurring drug use and sex, condom use at last intercourse, and unprotected intercourse during the prior 30 days. The factor structure of the RSS was consistent across age group (12-16 and 16-18 years) and across gender, and the links between the RSS subscales and health risk behaviors varied somewhat by gender but not by age group. These findings suggest that the RSS is an appropriate brief screening tool for predicting health risk behaviors among adolescents in substance abuse treatment.     

Association between adolescent substance use and obesity in young adulthood: A group-based dual trajectory analysis

Purpose

This study investigated whether and how trajectories of substance use in adolescence were associated with obesity trajectories in young adulthood. We hypothesized that: (1) exposure to persistent substance use throughout adolescence may heighten obesity risk in young adulthood; and (2) such associations may differ once gender, ethnicity, socioeconomic status, and obesity status in adolescence, are considered.

Methods

The study included 5141 adolescents from the child sample of the 1979 National Longitudinal Survey of Youth and utilized biennial data across the 12 assessments (1986–2008) to examine trajectories of substance use behaviors (i.e., cigarette smoking, alcohol use, and marijuana use) from ages 12 to 18 and obesity trajectories from ages 20 to 24. Group-based dual trajectory modeling was applied to examine sequential associations of trajectories of each type of substance use behavior with obesity trajectories.

Results

Three distinctive trajectory patterns were respectively identified for cigarette smoking, alcohol use, and marijuana use from ages 12 to 18, as well as for obesity status (BMI ≥ 30) from ages 20 to 24. Taking into account gender, ethnicity, socioeconomic status, and obesity status in adolescence, adolescents with the most problematic smoking trajectory (High-decreasing) were more likely to exhibit a High-obesity trajectory from ages 20 to 24. Also, adolescents with an Increasing marijuana use trajectory were more likely to exhibit an Increased obesity trajectory in young adulthood.

Conclusions

The current study demonstrates that adolescent substance use is associated with subsequent obesity in young adulthood. The associations appear to differ based on the type of substance use and patterns of use.     

Prior cigarette smoking initiation predicting current alcohol use: evidence for a gateway drug effect among California adolescents from eleven ethnic groups

Gateway drug theory provides a useful framework for understanding drug use among adolescent populations. Studies have reported a gateway effect of cigarette smoking on alcohol use among adolescents; but there is a lack of knowledge regarding ethnic differences in this effect. Using data from a cross-sectional survey in California, 11,239 subjects (46.3% male) from 31 high schools with at least 25% of total enrollment of Asian and at least 200 students with Asian ancestry entered the analysis. Among them, 6016 were ninth graders (mean age=14.3, S.D.=0.49) and 5223 were twelfth graders (mean age=17.3, S.D.=0.54). After controlling for seven variables, the risk ratio of last 30-day alcohol use among prior smoking initiators vs. noninitiators was 5.82 for non-Hispanic Whites, 4.25 for Blacks, 8.37 for Asian Indians, 3.99 for Chinese, 3.45 for Filipinos, 3.48 for Japanese, 5.41 for Koreans, 7.57 for Vietnamese, 4.02 for Mexicans, 2.64 for South/Central Americans, and 5.95 for adolescents with multiethnic background. Comparison of the 11 ethnic groups indicated that adolescents from different ethnic groups but with similar cultural background had a similar risk level; such pattern existed after controlling for acculturation, parents' monitoring, and school performance. The risk ratio did not differ by gender and grade. There is an association between prior cigarette smoking initiation and current alcohol use among adolescents from different ethnic backgrounds, including those of multiethnicity, which supports the generalizability of gateway drug effect of cigarette smoking on alcohol use. Studies should be conducted to investigate factors attributable to the ethnic variations of this association.     

Neural mechanisms of risky decision-making and reward response in adolescent onset cannabis use disorder

Background

Neural mechanisms of decision-making and reward response in adolescent cannabis use disorder (CUD) are underexplored.

Methods

Three groups of male adolescents were studied: CUD in full remission (n = 15); controls with psychopathology without substance use disorder history (n = 23); and healthy controls (n = 18). We investigated neural processing of decision-making and reward under conditions of varying risk and uncertainty with the Decision-Reward Uncertainty Task while participants were scanned using functional magnetic resonance imaging.

Results

Abstinent adolescents with CUD compared to controls with psychopathology showed hyperactivation in one cluster that spanned left superior parietal lobule/left lateral occipital cortex/precuneus while making risky decisions that involved uncertainty, and hypoactivation in left orbitofrontal cortex to rewarded outcomes compared to no-reward after making risky decisions. Post hoc region of interest analyses revealed that both control groups significantly differed from the CUD group (but not from each other) during both the decision-making and reward outcome phase of the Decision-Reward Uncertainty Task. In the CUD group, orbitofrontal activations to reward significantly and negatively correlated with total number of individual drug classes the CUD patients experimented with prior to treatment. CUD duration significantly and negatively correlated with orbitofrontal activations to no-reward.

Conclusions

The adolescent CUD group demonstrated distinctly different activation patterns during risky decision-making and reward processing (after risky decision-making) compared to both the controls with psychopathology and healthy control groups. These findings suggest that neural differences in risky decision-making and reward processes are present in adolescent addiction, persist after remission from first CUD treatment, and may contribute to vulnerability for adolescent addiction.     

Trends in alcohol-specific parenting practices and adolescent alcohol use between 2007 and 2011 in the Netherlands

BackgroundFollowing increased research and policy attention on the harmful effects of alcohol use among adolescents and the implementation of prevention programs aimed at reducing adolescent alcohol use, this study examined whether alcohol-specific parenting practices have become stricter and whether adolescent alcohol use has declined between 2007 and 2011 in the Netherlands.MethodsData were derived from three nationally representative cross-sectional studies of 12 to 16-year old adolescents – the Dutch National School Survey on Substance Use (2007 and 2011) and the Health Behaviour in School-aged Children (2009). These data were obtained using self-report questionnaires in the classroom (adolescents, M_age = 13.8 years, SD = .04) and at home (parents).ResultsBetween 2007 and 2011, Dutch parents increasingly adopted strict alcohol-specific practices, except for parents of 16-year old adolescents. Furthermore, adolescent reports of lifetime and last month alcohol use decreased, except for 16-year olds. The quantity of alcohol consumed by adolescents did not change between 2007 and 2011. Alcohol-specific parenting practices were associated with lower adolescent alcohol use. These associations were generally stable over time.ConclusionOur findings are consistent with the recent increased awareness in research, policy and the media about the harmful effects of alcohol on young people. Specifically, they are consistent with the focus of recent prevention efforts aimed at parents to postpone the alcohol use of their child at least until the age of 16. Future prevention programs should also target older age groups (i.e., age 16 years and older) and address the quantity of alcohol consumed by adolescents when they drink.     

Gambling and sexual behaviors in African-American adolescents

Objectives

Late adolescence represents a developmental risk period when many youth become involved in multiple forms of high-risk behaviors with adverse consequences. This study assessed the degree to which two such behaviors, adolescent sexual behaviors and gambling, were associated in a community-based sample with a large African-American presence.

Study design

Data are derived from a cohort study. This study focuses on 427 African-American participants with complete information on gambling and sexual behaviors by age 18 (72% of original cohort). Gambling involvement and related problems were based on responses to the South Oaks Gambling Screen — Revised for Adolescents. Several questions assessed sexual behaviors, including age of initiation. Multivariable logistic regression models adjusted for demographics, intervention status, impulsivity, depressive and anxiety symptoms, and alcohol and illegal drug use.

Results

Almost half of the sample (49%, n = 211) had gambled at least once before age 18. More gamblers than non-gamblers had initiated sexual intercourse by age 18 (aOR: 2.29 [1.16, 4.52]). Among those who had initiated sexual activity, more gamblers than non-gamblers with high impulsivity levels at age 13 (vs. low impulsivity levels) had become pregnant or had impregnated someone. Among those who had initiated sexual activity by age 18, more male gamblers had impregnated someone by age 18 as compared to female gamblers becoming pregnant.

Conclusions

Gambling and sexual behaviors often co-occur among adolescents. Such findings prompt the need for the inclusion of gambling, an often overlooked risky behavior, in behavioral prevention/intervention programs targeting adolescents.     

Parental influence on adolescent smoking cessation: is there a gender difference?

We examined the association of parental disapproval of adolescent smoking and parental smoking status, with past smoking quit behaviors among daily-smoking, high school-aged adolescents, and also tested whether these associations differ for boys and girls. Adolescent regular smokers (N = 253) completed questions on smoking behaviors, past smoking cessation behaviors, parental disapproval of smoking, and parental smoking. Past smoking cessation behaviors were defined as “the number of quit attempts that lasted longer than 24 hours” and “the longest number of days of abstinence”. Logistic regression analyses showed that for all adolescents, even having one smoking parent was associated with decreased odds of being abstinent for longer than 2 days. However, for girls, not having any smoking parents was associated with greater duration of abstinence (> 2 weeks). Having both parents, compared with not having any parents disapprove of smoking, was associated with greater number of quit attempts in boys, but this effect was not found in girls. The results indicate that parents have a salient role in adolescent smoking cessation behaviors, and this association appears to be gender-specific. However, further research is needed to understand the mechanisms that explain gender differences in parental influence on adolescent smoking cessation behaviors.     

Negative affect is associated with alcohol,but not cigarette use in heavy drinking smokers

Co-use of alcohol and cigarettes is highly prevalent, and heavy drinking smokers represent a large and difficult-to-treat subgroup of smokers. Negative affect, including anxiety and depressive symptomatology, has been associated with both cigarette and alcohol use independently, but less is known about the role of negative affect in heavy drinking smokers. Furthermore, while some studies have shown negative affect to precede substance use, a precise biobehavioral mechanism has not been established. The aims of the present study were twofold. First, to test whether negative affect is associated with alcohol and cigarette use in a large community sample of heavy drinking smokers (n = 461). And second, to examine craving as a plausible statistical mediator of the association between negative affect and alcohol and/or cigarette use. Hypothesis testing was conducted using a structural equation modeling approach with cross-sectional data. Analysis revealed a significant main effect of negative affect on alcohol use (β = 0.210, p < 0.05), but not cigarette use (β = 0.131, p > 0.10) in this sample. Mediational analysis revealed that alcohol craving was a full statistical mediator of this association (p < 0.05), such that there was no direct association between negative affect and alcohol use after accounting for alcohol craving. These results are consistent with a negative reinforcement and relief craving models of alcohol use insofar as the experience of negative affect was associated with increased alcohol use, and the relationship was statistically mediated by alcohol craving, presumably to alleviate negative affect. Further longitudinal or experimental studies are warranted to enhance the causal inferences of this mediated effect.     

Relations Between Parental Distress Intolerance,Adolescent Motives for Cigarette Use,and Adolescent Cigarette Smoking Levels

Background: A relatively large body of evidence indicates that coping motives for cigarette smoking are associated with a number of problematic outcomes (e.g., greater smoking frequency) among adolescents. Evidence also indicates that lower distress tolerance (or higher distress intolerance) is related to higher levels of coping motives for cigarette smoking among adults and adolescents. Therefore, it is critical to improve our understanding of factors that may increase the likelihood of smoking to cope among adolescents. In addition, evidence suggests that a number of parenting behaviors may affect adolescent smoking behavior. No work to date, however, has examined the relation between parental distress intolerance and adolescent smoking motives, or adolescent smoking behavior. Objective/methods: The current study involving adolescents (n?=?46) and one of their parents aimed to address this gap in the literature by examining the association between parent-reported parental distress intolerance, self-reported adolescent motives for cigarette use, and self-reported adolescent cigarette smoking levels. Results: Results indicated that parental distress intolerance was related to greater adolescent coping motives for cigarette smoking, but not to other motives for adolescent cigarette use. Furthermore, results indicated that parental distress intolerance was indirectly associated with higher adolescent cigarette smoking levels through adolescent coping motives for cigarette smoking. Conclusions: Parental distress intolerance is associated with coping motives for adolescent cigarette smoking. This suggests parental emotional factors may be associated with adolescent cigarette use.