Children are far more likely to try and take up cigarette smoking if their parents or friends are smokers, new prospective findings confirm.

The data highlight the ‘transmissible’ nature of the tobacco epidemic in young people and support the need for further urgent and comprehensive action on smoking to protect children, the researchers report in Thorax.

Using data on more than 11,500 children across the UK they showed teens aged about 14 years whose main caregiver smoked were more than twice as likely to have tried cigarettes than those whose caregivers did not smoke (26% vs 10.9%). They were also more likely to be a current smoker (4.9% vs 1.2%).

The study also showed that 35.1% of teens who reported at least some of their friends smoked had tried cigarettes compared to 4% of those whose friends did not smoke, with evidence of a dose-response effect between friend smoking and child smoking.

Speaking to the limbic about the new findings, senior author Dr Nicholas Hopkinson from the National Heart & Lung Institute at Imperial College, London, said:

“We have shown tobacco addiction is transmitted from parents to children and between groups of children, and that there is a very striking difference between trying cigarettes depending on whether or not your friends smoke.”

He says that while the findings are perhaps not surprising they are novel because they are based on data from the Millennium Cohort Study, which has been following children across the UK born between September 2000 and January 2002, and so add prospective evidence to that from other large cross-sectional surveys suggesting links between caregiver smoking and smoking uptake.

“Because it’s the Millennium Cohort Study we have children and parents who have been studied at repeated time points, so you can look accurately at past exposures because they were measured at the time rather than being based on recall,” he explained.

Dr Hopkinson says it’s important to recognise what the key drivers are for children trying and taking up smoking so interventions can be tailored to address them. Making sure people don’t take up smoking is the only way, aside from helping current smokers quit, to achieve the Government’s Tobacco Control Plan target of a ‘smoke-free generation’, he added.

He believes smoking cessation needs to be tackled holistically as well as in terms of specific interventions, such as school-based strategies.

“We know that advertising with stop smoking messages is effective, so that needs to be invested in.

“We also need to make sure the health system is doing its job in helping parents to quit smoking, particularly women when they are pregnant,” he said, pointing to a further finding from the study that children whose mothers smoked during pregnancy were more likely to try and take up smoking.

“It needs to be recognised as a specific problem by agencies across the health and social care system that prospective parents and parents who smoke and their children are a group at particular risk, where help needs to be offered.”

According to Dr Hopkinson, there is a concern that smoking may become invisible as overall smoking prevalence declines in the UK. He warns that the latest figure showing the rate of smokers has fallen to 15.1% masks a great deal of inequality.

“We need to remember that smoking is still a major health problem for particular groups of people, like those who are poorer and those with mental health problems, ” he said.