Transition in Cigarette Smoking Stages and its Relation with Parenting Styles of Parents among Iranian High School Students: A Longitudinal Study

Background: Smoking is increasing among adolescents, and family is a factor influencing it. The present study aimed to examine the relationship between transition in smoking stages and parenting styles of parents of adolescents. Materials and Methods: This was a longitudinal study in which 3968 high school students in Tabriz, Iran, were examined from November 2017 to June 2018. Sampling was multi-stage, with proportional and random clusters. A questionnaire containing demographic information and potential confounders were filled in by students, and the Parenting Style Inventory was completed by parents only in the first stage. Moreover, students twice (in the beginning of the study and six months later) completed a valid algorithm of stages of cigarette smoking. Data were analyzed using univariate and multivariate logistic regression analysis. Results: After the six-month interval, 429 students (11.7%) with a 95% Confidence Interval (CI) (10.68 - 12.76) progressed through the stages of smoking. By controlling potential confounding variables, the father’s permissive parenting style compared to the authoritative style increases the odds of progress through the stages of smoking by almost five times (OR=5.06, 95% CI: 2.58 - 9.93), and the father’s authoritarian parenting style compared to the authoritative style increases the odds of progress through the stages of smoking by almost four times (OR=4.01, 95% CI: 2.17 - 7.40). Conclusion: Inefficient parenting styles are an important risk factor for progress through the stages of cigarette smoking in adolescents. Desirable relationships between parents and children as well as parents’ awareness of parenting styles may prevent smoking in adolescents.