Effects of Household Socialization on Youth Susceptibility to Smoke: Differences Between Youth Age Groups and Trends Over Time

A Canadian biennial youth survey facilitated repeating investigation of susceptibility to smoke and household socialization. We operationalized susceptibility to smoke by 3 levels on the basis of intention and behavior. Variables consistently predicting greater susceptibility across time and age groups were sibling smoking, household restrictions, and vehicle smoke exposure. Gender was predictive among older youths. Household restrictions and emerging legislation to ban smoking in vehicles with youth passengers provide protection against secondhand smoke exposure and sustained resolve to remain smoke-free.Supporting youths to remain smoke-free is an ongoing global public health priority.1 Preventative strategies, clean air policies, higher tobacco taxes, community- or school-based programs, tobacco-marketing bans, and age restrictions on tobacco purchases1–3 are effective in diminishing tobacco use among those aged 18 years and younger. Still, because every youth begins life as a nonsmoker with no intention of using tobacco, it is imperative to research socialization mechanisms in diverse contexts.4Youth smoking rates in developed countries vary,5–8 but a common trend among youths older than 15 years is higher rates of both tobacco use and weakened certainty of never smoking in the future.5–8 Tobacco use among youths’ social networks appears to have a stronger influence on their smoking behaviors than do population health strategies.9–15 Alternately, household smoking bans prevent secondhand smoke exposure and function as a denormalization strategy to support sustained resolve to remain smoke-free and not start smoking,16–18 regardless of the smoking status of parents living in the home.19 Prohibiting smoking in cars with children is in early phases of legislation adoption globally; Canada and Australia have widely adopted this law, and 4 of the 50 states in the United States have taken this action.20 When youths reported riding in a vehicle with a person who was smoking in the past week, they were less likely to feel certain about never smoking in the future; thus, their resolve to remain smoke-free was weaker.19Household context has a role in shaping youths’ resolve to remain smoke-free; one’s perception of susceptibility (i.e., future intention) to smoke is strongly associated with future smoking behaviors.4 We performed a secondary analysis of the Canadian 2006–2007 Youth Smoking Survey (YSS) to examine household contextual variables’ influence on youths’ (grades 5–12) intentions and behaviors related to smoking. The study partially replicates a study of the 2004–2005 YSS that included youths in grades 5 to 9.19