Childhood socio-economic position and adult smoking: are childhood psychosocial factors important? Evidence from a British birth cohort.

BACKGROUND Childhood socio-economic position (SEP) is associated with adult smoking status. Previous studies have investigated mediation by educational attainment. The aim of this study is to examine whether childhood psychosocial factors (cognitive ability, psychosocial adjustment and parental involvement) are important in the association between childhood SEP and adult smoking status over and above educational attainment in a large prospective birth cohort study. METHODS Data on 7709 participants from the National Child Development Study birth cohort from Great Britain were used in this study. Multinomial logistic regression was used to examine the associations of childhood SEP and childhood psychosocial factors with adult smoking status, both bivariate and mutually adjusted, and then additionally adjusted for confounders and participant's educational attainment. Analyses were conducted separately for men and women. RESULTS Childhood SEP is an important determinant of adult smoking status, even after adjustment for childhood psychosocial factors and educational attainment. Parental involvement, cognitive ability and psychosocial adjustment were all associated with adult smoking status for both men and women. Also parental involvement for men, and both parental involvement and psychosocial adjustment for women, remain important determinants of adult smoking status over and above childhood SEP, other childhood psychosocial factors and educational attainment. CONCLUSIONS These findings add to the evidence base that childhood disadvantage is associated with adult smoking behaviours and highlights the importance of the early childhood social environment for the development of these.