Childhood psychopathology and adolescent cigarette smoking: a prospective survival analysis in children at high risk for substance use disorders.

Children of parents with substance use disorders (SUDs) have been shown to demonstrate an increased risk for cigarette smoking in adolescence. In this prospective study, we hypothesized that adolescent cigarette smoking risk would be accounted for by childhood disruptive behavior disorders and parent cigarette smoking. Preadolescent children (ages 10-12 years) of fathers with SUD considered at high average risk (HAR; n=274) and children of fathers without SUD or major psychopathology considered at low average risk (LAR; n=298) participated in structured interviews to determine mental disorder diagnoses and substance use history. Both parents were assessed. The age of onset of daily tobacco use was determined in three follow-up assessments conducted through late adolescence. Conduct disorder (CD) and parental smoking predicted earlier daily cigarette smoking, and mediated the relationship between risk status and offspring daily cigarette smoking. Through the identification of childhood characteristics predicting daily cigarette smoking in adolescence, these results may facilitate targeting of early childhood preventive interventions.