Families, Systems, & Health 2015, Vol. 33, No. 3, 314 –323
In the public domain http://dx.doi.org/10.1037/fsh0000137
The Influence of Nonresident Fathers on Adolescent and Young Adult Cigarette Smoking Mir M. Ali, PhD and David Dean Jr., PhD Substance Abuse and Mental Health Services Administration, Rockville, Maryland Introduction: In this analysis we examine the relationship between nonresidential father involvement with their children and adolescent smoking behavior using a nationally representative longitudinal dataset. We attempt to determine what influence, if any, nonresident fathers have in the development of this health risk behavior in their adolescent children while accounting for aspects of parenting and family life that have been hypothesized to also influence adolescent cigarette smoking. Method: Data for this analysis come from the first 3 waves of the Longitudinal Study of Adolescent to Adult Health. Given the longitudinal nature of the data, we are able to ascertain whether nonresident father involvement affects adolescent cigarette smoking, an important advance in our understanding of the influence of fathers. Results: We found that greater levels of nonresidential father involvement significantly decrease both the odds of participation in and the intensity of cigarette smoking, especially among girls. This influence is demonstrated not only in adolescence but persists into young adulthood. Discussion: Our findings underscore the importance of adolescents’ living arrangements and the role that nonresident fathers might play in influencing adolescent cigarette smoking, a health risk behavior of strong public health significance. Fathers make important contributions to the health and wellbeing of their children, and interventions focused on nonresident fathers in particular would likely be of significant help to the substance abuse prevention field. Interventions to support father involvement, particularly of nonresident fathers, with their children should be implemented as a preventive strategy to reduce the likelihood of adolescent cigarette smoking. Keywords: adolescence, cigarette smoking, fathers, young adulthood
In the last 40 years, the nature of marriage and family in the United States has changed statistically significantly, with married couples accounting for about 70% of households in 1970 to only 49% of households in 2012 (Vespa, Lewis, & Kreider, 2013). About 60% of households with children under 18 years old in 2012 consisted of a married couple, and of those a considerable proportion (15%) were made up of at least one nonbiological (i.e., step-parent)
This article was published Online First June 1, 2015. Mir M. Ali, PhD and David Dean Jr., PhD, Analysis and Services Research Branch, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Correspondence concerning this article should be addressed to David Dean Jr., PhD, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD 20857. Email: [email protected]
parent (U.S. Census Bureau, 2013). Although a majority of fathers reside with their children under 18, about one-quarter have at least one child who does not physically reside with him (Jones & Mosher, 2013). Adolescents are living in what has historically been identified as “nontraditional” families characterized by mothers, often the primary custodial parent, and fathers who no longer reside together. The wellestablished link between parents and their offspring in substance use and abuse requires further investigation to identify risk and protective factors associated with this health risk behavior, particularly the role of nonresident fathers in this increasingly non-nuclear American family (Carr & Springer, 2010; Windle, 2000). Given the significant public health problem of youth cigarette smoking, in this analysis we focus on the role of nonresident fathers in the development of adolescent smoking using a nationally representative longitudinal dataset to examine the nature of this influence.
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Fathers have increasingly become the focus of developmental and family systems researchers. The historical assumption of little (or only positive) fathers’ influence was evident in most research through the early ’90s, with the important exception being the literature on the children of alcoholics and the lasting effects of a father’s alcohol abuse on their children from adolescence to adulthood. Since that time, researchers have empirically established their influence, particularly relative to the influence of mothers, in psychopathology and substance use in particular (Adamsons & Johnson, 2013; Choi, 2010; Jones & Mosher, 2013; Murphey et al., 2014; Phares & Compas, 1992). Different empirical and theoretical perspectives account for this influence in different ways, such as fathers’ behavioral modeling described by Social Learning Theory or fathers as a source of values or attitudes in social– cognitive models like the Theory of Planned Behavior (Bandura, 1977; Fishbein & Ajzen, 2011). The analyses described here reflect these empirical and theoretical perspectives through the integrative framework described by “life-course health development” that attempts to describe contextual influences on individual behavior and account for the role of systems in which development occurs (Halfon & Hochstein, 2002). Public policies adopted by the federal government, such as the “responsible fatherhood” initiatives begun during the Bush administration and continued by the Obama administration, reflect the growing understanding of the important role of fathers, beyond their financial contributions, in the positive development of children and prevention of deleterious adolescent behaviors (Solomon-Fears, 2014). Adolescent smoking continues to be a significant public health issue as it is one of the top four substances abused by adolescents (Substance Abuse and Mental Health Services Administration, 2013). The well-documented short-term and long-term health consequences of adolescent cigarette smoking can be compounded by its association with other, cooccurring behavioral issues. It also disproportionately affects vulnerable populations, such as those of low socioeconomic status (SES), some ethnic minority groups, and lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth (Lee, Griffin, & Melvin, 2009; U.S. Department of Health & Human Services, 2014).
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Cigarette smoking behavior typically becomes established in adolescence, and is, therefore, a prime candidate for prevention efforts during this developmental period. Indeed, many researchers and policy advocates have emphasized the importance of focusing prevention and treatment resources on adolescents in order to improve their, and the population’s, long-term health (Bruvold, 1993). Because of their role as models and social supporters, parents and families are frequent targets of research on influential factors in adolescent cigarette smoking as well as effective preventive interventions (Lantz et al., 2000; Mendez, Ogg, Loker, & Fefer, 2013; Menning, 2006; Robertson, David, & Rao, 2003; U.S. Department of Health & Human Services, 2014). Researchers have investigated the characteristics of families, such as structures (of the residential and/or biological family), transitions (in parental relationships and residence), and processes (e.g., parental behaviors, economic hardship), that are associated with child health and well-being (Carr & Springer, 2010). In this analysis, we focus on a large subset of “disrupted” families in the National Longitudinal Study of Adolescent to Adult Health and investigate the role of nonresident fathers in adolescent cigarette smoking. Using family data, we attempt to determine what influence, if any, nonresident fathers have in the development of this health risk behavior in their adolescent children while accounting for aspects of parenting and family life that have been hypothesized to also influence adolescent cigarette smoking. Given the longitudinal nature of the data, we are able to ascertain whether nonresident father involvement affects adolescent cigarette smoking, an important advance in our understanding of the influence of fathers (Hawkins, Amato, & King, 2007). Method Data Source and Analysis Sample The data for this study come from the National Longitudinal Study of Adolescent to Adult Health (henceforth “Add Health”). Add Health is a longitudinal survey of U.S. adolescents in 132 schools nationwide enrolled in Grades 7 to 12 in 1994 –1995 (Wave I), with follow-up surveys in 1996 (Wave II), 2001–
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2002 (Wave III), and 2007–2008 (Wave IV) (Harris et al., 2009). Add Health was initially approved by the institutional review board at the University of North Carolina–Carolina Population Center (Chapel Hill, North Carolina). A unique feature of Add Health is that it collects extensive information on not only adolescents’ smoking behavior but also characteristics of their relationship with their nonresident father and aspects of parental involvement with their respondent children. To that end, Add Health interviewed one of the parents (mostly mothers) of each respondent as part of the survey in 1994. This parent survey is our primary source for measuring family characteristics such as family structure and household financial information, such as whether the nonresident father pays child support and whether the primary caregiver was on welfare. Also, the longitudinal nature of the data allows us to examine the long-term relationship between nonresident father involvement and adolescent smoking. The data for our analysis come from the first three waves of the survey. The sample for our analysis includes all individuals less than 18 years of age in Wave II who were interviewed in all of the first three waves of the study, with nonmissing information for one or more of the variables used in our analysis, who had a nonresident biological father but were living with their biological mothers, and was a nonsmoker in Wave I (N ⫽ 3,100). Table 1 reports summary statistics for the outcome measures and all control variables used in our analysis. Measures In our analysis we focus on both current cigarette use, with the question, “During the past 30 days, on how many days did you smoke cigarettes?” (dichotomized to none or 1⫹) and the intensity of use, with the questions, “During the past 30 days, on how many days did you smoke cigarettes?” and “During the past 30 days, on the days you smoked, how many cigarettes did you smoke each day?” For current use, we thus have a binary variable reflecting cigarette use. For intensity, we multiplied the responses to both questions to generate a continuous variable and further transformed it using the natural log of the positive values for those responses to be able to interpret the coefficients of explanatory variables as elasticities.
The key independent variable of interest is the nonresident fathers’ involvement with the adolescents. Following Menning and Stewart (2008) and Stewart and Menning (2009), the measure of nonresident father involvement was constructed using 11 indicators present in Wave I of the survey (Cronbach’s alpha ⫽ .80). Adolescents were asked how close they were to their nonresident fathers, ranging from 1 (not close at all) to 5 (extremely close), how often they had stayed overnight with him during the past year, from 0 (not at all) to 5 (more than once a week), and a series of nine questions about whether they had participated in various activities such as going shopping, going to a movie, or working on a project for school with their nonresident father (1 ⫽ yes, 0 ⫽ no). These measures were then summed and standardized (to have a mean of 0 and a standard deviation of 1) to create a measure of nonresident father involvement (Menning & Stewart, 2008; Stewart & Menning, 2009). Other measures related to nonresident fathers include an indicator for whether the nonresident father was a smoker or not, his level of education (less than high school, high school, some college, or college graduate), and whether he paid monthly child support (Amato & Gilbreth, 1999; Cheadle, Amato, & King, 2010; King & Sobolewski, 2006; Menning, 2006). Because our sample is restricted to those who lived with their biological mothers, we account for the household family structure of the adolescent by the presence (or absence) of another man in the household: living with biological mother and a nonbiological father, living with biological mother and mother’s unmarried partner, or living with biological mother only. Because Add Health interviewed one of the parents (mothers in the case of this analysis), we were also able to control for a number of biological mother’s characteristics including whether the mother had a college degree, whether the mother received welfare, whether the mother is a smoker, and whether the mother lives in the current location because of the school district. Other controls in our model include whether the adolescents have easy access to cigarettes in their home, percentage of their classmates who are smokers, whether they are religious, their selfrated health and demographic characteristics such as age, gender, race, and whether they were born in the United States.
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Table 1 Descriptive Statistics Variables Dependent variable Cigarette use Intensity (natural log) Cigarette use Intensity (natural log) Nonresident father characteristics Involvement scale (standardized) Smoker College Child support Demographic characteristics Male Age Race White Black Hispanic Other Grade Seven Eight Nine Ten Eleven Twelve Family structure Born USA Religious Ease of cigarettes availability Self-rated good health Classmates smoke Age Education Currently married Self-rated good health Religious Mother characteristics College Received welfare Smoker N
Wave
Mean
Standard deviation
Min
Max
II II III III
0.51 3.81 0.34 5.22
0.49 2.21 0.47 1.54
0 0 0 0
1 7.50 1 10.31
I I I I
0.00 0.67 0.05 0.55
1.00 0.47 0.22 0.50
⫺1.50 0 0 0
2.72 1 1 1
II II II
0.34 15.18
0.47 1.45
0 12
1 17
0.49 0.33 0.14 0.04
0.50 0.45 0.35 0.20
0 0 0 0
1 1 1 1
0.09 0.11 0.14 0.20 0.22 0.21 1.76 0.82 0.54 0.26 0.71 0.54 22.03 2.28 0.17 0.94 0.51
0.09 0.32 0.31 0.34 0.36 0.34 0.56 0.38 0.50 0.44 0.46 0.15 1.79 0.73 0.38 0.22 0.50
0 0 0 0 0 0 1 0 0 0 0 0 18 1 0 0 0
1 1 1 1 1 1 3 1 1 1 1 1 27 3 1 1 1
0.22 0.29 0.36
0.41 0.45 0.48
0 0 0
1 1 1
II
II II II II II I III III III III III I I I
Analysis Plan For our binary indicator of smoking (cigarette use) we estimated a logistic regression model and for our continuous measure of smoking (intensity) we estimated an ordinary least square regression (OLS) for those who are smokers using StataSE 13 (StataCorp, 2013). Regression estimates of the effect of the relationship with nonresident father on smoking behavior may be subject to bias from at least
3,100
two sources, both of which we attempted to address empirically. First, common unobserved environmental factors may confound the effect of the nonresidential father involvement on cigarette use. These could include factors such as cigarette prices/taxes, a lower opportunity cost of engaging in smoking attributable to ease of availability, the percentage of the population in poverty, and so on. These could also include school size, region, economic and sociocultural factors. Second, the estimated effect of the re-
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lationship with nonresident father may be due to reverse causality or simultaneity. For example, it could be that adolescents who are more prone to smoking are also less likely to have a good relationship with their nonresident father. If either of these problems is present, the regression estimator will be inconsistent and will not have a causal interpretation. We try to address these potential problems using the following empirical strategies. First, our longitudinal data allow us to use a lagged measure of the nonresident father involvement. This strategy would address the problem of reverse causality assuming smoking in period t cannot influence the adolescent’s relationship with their nonresident father in period t ⫺ 1. Thus, in our case adolescent smoking indicators are drawn from Wave II and Wave III of the Add Health survey and the relationship with nonresident father is drawn from Wave I. Also, as noted previously, our analysis sample consists of adolescents who were not smokers in Wave I, which further allows us to avoid any remaining confounding factors related to reverse causality. In addition, the longitudinal nature of our data allows us to estimate both the short-term and long-term effect of nonresident father involvement on smoking—something that was not done in prior studies. Second, we address unobserved school-level confounders by introducing a vector of school-specific dummy variables in our model. These schoollevel fixed effects will account for any common environmental characteristics at the school level that may be correlated with both nonresident father involvement and smoking. For example, an adolescent who attends a school where poverty rates and crime are high, access to cigarettes is easy, and public recreational facilities are scarce may be more likely to smoke and also less likely to engage in activities with their nonresident father. Results Table 2 presents our estimates of the effect of nonresidential father involvement in Wave I (1994 –1995) on smoking behaviors in 1996 (Wave II), with the second column containing logistic estimates (odds ratio) on use and column four reporting the estimates from OLS regression on intensity, after accounting for the Add Health complex survey design. The coef-
ficients of the intensity model represent elasticity since our consumption measure is in natural log form, that is, a coefficient times 100% is approximately equal to the percentage change in the number of cigarettes smoked for one unit change in the independent variable. These models have been estimated using the lagged (Wave I) measure of nonresident father involvement and control for school-level fixed effects. The estimates show an inverse relationship between nonresidential father involvement and smoking. More specifically, a one–standard deviation increase in nonresident father involvement is associated with a 14% decline in the odds of an adolescent becoming a smoker and a 2.5% reduction in the number of cigarettes smoked by an adolescent smoker during the past month. The estimates on easy access to cigarettes and nonresidential father smoking reflect the expected relationship— easy access to cigarettes and nonresidential father smoking are both positively correlated with smoking. Other control variables, such as demographic characteristics and parental measures, also reflect the expected relationships. After stratifying the estimates by gender (see Table 3), the effect of nonresident father involvement on smoking participation appears to be approximately the same for both adolescent girls and boys. However, for the intensity measure the estimates appear slightly larger for girls, for whom the reduction in smoking intensity is approximately 3.1% compared with a reduction of 1.1% for boys, a difference that was not statistically significant. Because the estimates of the control variables exhibit a pattern similar to the results in Table 2, we only report the results for the measure of nonresidential father involvement. Table 4 presents estimates with smoking behaviors measured in 2002 (when most of the adolescents have made the transition to young adulthood) and the nonresident father involvement measured in 1994 –1995. The results suggest that the level of nonresidential father involvement from adolescence continues to be associated with smoking participation even after the adolescents makes the transition into young adulthood. In particular, the results show that a one–standard deviation increase in nonresident father involvement is associated with a 13% decline in the odds of the individual being a smoker. However, the effect on number of
NONRESIDENT FATHERS AND YOUTH CIGARETTE SMOKING
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Table 2 Effect of Wave I (1994 –1995) Nonresident Father Involvement on Wave II (1996) Smoking Cigarette use Variables Nonresident father characteristics Involvement scale (standardized) Smoker College Child support Demographic characteristics Male Age Race White Black Hispanic Grade Seven Eight Nine Ten Eleven Twelve Six (reference category) Family structure Born USA Religious Ease of cigarettes availability Self-rated good health Classmates smoke Mother characteristics College Received welfare Smoker Adjusted R2 N ⴱ
p ⬍ .1.
ⴱⴱ
p ⬍ .05.
ⴱⴱⴱ
Intensity
Odds ratio
95% confidence interval
Coefficient
Standard error
0.86ⴱⴱⴱ 1.16 0.92 0.97
0.78, 0.96 0.97, 1.51 0.83, 1.03 0.78, 1.19
⫺0.25ⴱⴱⴱ 0.27 0.18 ⫺0.31ⴱⴱ
0.08 0.17 0.21 0.15
1.12 0.96
0.92, 1.37 0.84, 1.09
0.15 0.20ⴱⴱ
0.14 0.09
1.20 0.37ⴱⴱⴱ 1.50
0.67, 2.14 0.21, 0.68 0.78, 2.88
0.68 ⫺0.96ⴱⴱ 0.32
0.48 0.48 0.53
0.54 0.31ⴱⴱⴱ 0.36ⴱⴱⴱ 0.45ⴱⴱⴱ 0.41ⴱⴱⴱ 0.61ⴱⴱⴱ
0.18, 1.63 0.17, 0.60 0.21, 0.64 0.29, 0.70 0.28, 0.60 0.42, 0.88
⫺0.08 0.06 ⫺0.20 0.25 ⫺0.06 ⫺0.33
0.75 0.43 0.37 0.29 0.25 0.24
1.03 0.92 0.73ⴱⴱⴱ 1.84ⴱⴱⴱ 0.83 1.13
0.87, 1.22 0.70, 1.22 0.60, 0.90 1.50, 2.25 0.56, 1.23 0.97, 1.31
0.15 0.21 ⫺0.52ⴱⴱⴱ 0.70ⴱⴱⴱ ⫺0.75ⴱⴱⴱ ⫺0.01
0.12 0.20 0.16 0.15 0.26 0.09
0.92 1.13 1.14
0.71, 1.19 0.90, 1.42 0.93, 1.41
⫺0.46ⴱⴱ 0.33ⴱ 0.19
0.20 0.17 0.16
0.158 3,100
0.285 1,500
p ⬍ .01.
cigarettes smokes (intensity) is not statistically significant. After stratifying the estimates by gender, the effect continues to be larger for young women. Discussion In this analysis we used a nationally representative survey of adolescents to examine the relationship between nonresident father involvement and smoking behavior. Utilizing the longitudinal characteristics of the data enabled us to address the potential reverse causality in the relationship between nonresident father involvement and adolescent smoking, and the use of school fixed effects allowed for the control of many unobservable potential confounders at the
school and community level. In addition, the longitudinal aspect of the data also allowed us to estimate both the long-term and short-term impact of nonresidential father involvement. We find that greater levels of nonresidential father involvement significantly decrease both the odds of participation in and the intensity of cigarette smoking, especially among girls. This influence is demonstrated not only in adolescence but persists into young adulthood. Although it is beyond the scope of our analysis to investigate why this effect appears to be larger for girls, we suspect that the different ways in which boys and girls continue to be socialized, as well as differing expectations regarding their activities and relationships with mothers and fathers, may account for this difference (Lytton
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Table 3 Effect of Wave I (1994 –1995) Nonresident Father Involvement on Wave II (1996) Smoking: Stratified by Gender Smoker Variables
Odds ratio
Males Involvement scale (standardized) N Females Involvement scale (standardized) N ⴱ
p ⬍ .1.
ⴱⴱ
p ⬍ .05.
ⴱⴱⴱ
95% confidence interval
0.86ⴱⴱ
0.73, 0.99
Number of cigarettes smoked Coefficient ⫺0.11
1,054 0.85ⴱⴱ
Standard error 0.13 495
0.73, 0.99
⫺0.34ⴱⴱⴱ
2,046
0.12 1,005
p ⬍ .01.
& Romney, 1991; Witt, 1997). In addition, recent literature has also shown differential effects by gender in adolescent smoking-related outcomes (Ali, Amialchuk, & Heller, 2015). Although this is an important contribution to the fatherhood and substance abuse prevention literature, we should acknowledge several caveats relevant to this analysis. Our model is limited, of course, to the variables measured in the Add Health study; we were not able to account for all of the potential confounders of the relationship between nonresident father involvement and adolescent cigarette use. For instance, we were unable to capture aspects of the diversity of nonresident father families, such as the range of family living and custodial arrangements as well as remarriage and blended family effects. We were unable to account for whether fathers were ever present in the family home or moved out at a particular time in their child’s life. The timing of life transitions, such as parental divorce, is an important factor in the lives
of children that has been linked to substance use initiation and escalation of use (Carr & Springer, 2010). Despite these limitations, we identify several strengths of these analyses that we believe add to the literature, particularly aspects of the study design that that have been called for by researchers in this topic (Carr & Springer, 2010) and extends progress in it (Menning, 2006). First, our use of the nationally representative Add Health dataset permits us to make wellsupported generalizations regarding U.S. youth. The longitudinal nature of the data allows us to interpret the association between father involvement at Wave I as having a causal effect on adolescent behavior at Wave II and young adult behavior at Wave III. This assessment demonstrates both the short- and long-term effects of nonresident father involvement, another advance for the literature. Also, studies in family systems are sometimes criticized for a focus on individuals rather than actual family dynamics,
Table 4 Effect of Wave I (1994 –1995) Nonresident Father Involvement on Wave III (2002) Smoking Smoker Variables
Odds ratio
Full sample Involvement scale (standardized) N Males Involvement scale (standardized) N Females Involvement scale (standardized) N ⴱ
p ⬍ .1.
ⴱⴱ
p ⬍ .05.
ⴱⴱⴱ
p ⬍ .01.
Number of cigarettes smoked
Confidence interval
Coefficient
0.79, 0.96
⫺0.08
0.87ⴱⴱⴱ 3,100 0.92
0.79, 1.05
⫺0.14
0.08 338
0.72, 0.95 2046
0.06 1,300
1054 0.83ⴱⴱⴱ
Standard error
⫺0.04
0.08 962
NONRESIDENT FATHERS AND YOUTH CIGARETTE SMOKING
and we have been able to perform, essentially, a dyadic, family-level analysis. In this case, too, the individual family member is the informant, rather than having the parent as an informant on child behavior, which is a strong indicator of the validity and reliability of the reported variables. Finally, in our analysis we were able to account not only for whether nonresident father influence exists for cigarette smoking in children but also on the nature of that influence (through involvement) and various other family and community characteristics. These findings suggest that the effects of growing up with a nonresident father persist from adolescence through young adulthood and affect an adolescent risk behavior of strong public health significance. For at least the last two decades, researchers have been investigating the influence of fathers in the development and well-being of children in depth that had previously been focused on the influence of mothers (Adamsons & Johnson, 2013; Amato & Gilbreth, 1999; Phares & Compas, 1992). Mothers had arguably received a great deal of the credit and blame for both positive and negative outcomes for their children, whereas fathers were regarded as relatively benign actors whose influence was assumed to be largely positive, if it existed (Adamsons & Johnson, 2013). Our findings demonstrate the important contributions fathers make to the health and wellbeing of their children, a result increasingly evident in the research literature on fatherhood, and suggest that interventions focused on nonresident fathers in particular would likely be of significant help to the substance abuse prevention field. It is clear that interventions to foster father involvement, particularly of nonresident fathers, with their children should be implemented as a preventive strategy to reduce the likelihood of adolescent cigarette smoking. Efforts such as the federal “responsible fatherhood” initiatives could address the unique circumstances of nonresident fathers in establishing and maintaining positive, quality relationships with the children, an important goal supported by governmental and nongovernmental policy recommendations and efforts (Murphey et al., 2014; Solomon-Fears, 2014). Such efforts should continue to target at-risk families identified to have parents in need of skills-based interventions to foster better involvement as well as monitoring and other spe-
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cific parenting practices that ensure positive youth outcomes. Clinicians should be aware of the role of both resident and nonresident fathers, particularly given the historical assumption of the neutral or solely positive impact of fathers. Resources such as the AMA Guide for Adolescent Preventive Services and the recommendations of the US Preventive Services Task Force reflect the need for clinicians and other care providers to recognize the importance of families, particularly parents, and engaging them in their efforts to prevent problem behavior and raise healthy children (American Medical Association, 1997; Knishkowy & Palti, 1997; U.S. Preventive Services Task Force, 2009, 2013). Future research should continue to address the nature of good parenting practices as well as the impact of such practices on other substances of abuse in adolescence.
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Choi, J. K. (2010). Nonresident fathers’ parenting, family processes, and children’s development in urban, poor, single-mother families. Social Service Review, 84, 655– 677. http://dx.doi.org/10.1086/ 657422 Fishbein, M., & Ajzen, I. (2011). Predicting and changing behavior: The reasoned action approach. New York, NY: Taylor & Francis. Halfon, N., & Hochstein, M. (2002). Life course health development: An integrated framework for developing health, policy, and research. The Milbank Quarterly, 80, 433– 479, iii. http://dx.doi.org/ 10.1111/1468-0009.00019 Harris, K. M., Halpern, C. T., Whitsel, E., Hussey, J., Tabor, J., Entzel, P., & Udry, J. R. (2009). The National Longitudinal Study of Adolescent Health: Research design. Retrieved from http://www.cpc .unc.edu/projects/addhealth/design Hawkins, D. N., Amato, P. R., & King, V. (2007). Nonresident father involvement and adolescent well-being: Father effects or child effects? American Sociological Review, 72, 990 –1010. http://dx .doi.org/10.1177/000312240707200607 Jones, J., & Mosher, W. D. (2013). Fathers’ involvement with their children: United States, 2006 – 2010. National Health Statistics Reports, 71, 1–21. King, V., & Sobolewski, J. M. (2006). Nonresident fathers’ contributions to adolescent well-being. Journal of Marriage and Family, 68, 537–557. http://dx.doi.org/10.1111/j.1741-3737.2006 .00274.x Knishkowy, B., & Palti, H. (1997). GAPS (American Medical Association Guidelines for Adolescent Preventive Services). Where are the gaps? Archives of Pediatrics & Adolescent Medicine, 151, 123–128. http://dx.doi.org/10.1001/archpedi.1997 .02170390013002 Lantz, P. M., Jacobson, P. D., Warner, K. E., Wasserman, J., Pollack, H. A., Berson, J., & Ahlstrom, A. (2000). Investing in youth tobacco control: A review of smoking prevention and control strategies. Tobacco Control, 9, 47– 63. http://dx.doi.org/ 10.1136/tc.9.1.47 Lee, J. G., Griffin, G. K., & Melvin, C. L. (2009). Tobacco use among sexual minorities, USA, 1987–2007 (May): A systematic review. Tobacco Control, 2008.028241. http://dx.doi.org/10.1136/tc .2008.028241 Lytton, H., & Romney, D. M. (1991). Parents’ differential socialization of boys and girls: A metaanalysis. Psychological Bulletin, 109, 267–296. http://dx.doi.org/10.1037/0033-2909.109.2.267 Mendez, L. R., Ogg, J., Loker, T., & Fefer, S. (2013). Including Parents In The Continuum Of SchoolBased Mental Health Services: A review of intervention program research from 1995 to 2010. Journal of Applied School Psychology, 29, 1–36. http://dx.doi.org/10.1080/15377903.2012.725580
Menning, C. L. (2006). Nonresident fathers’ involvement and adolescents’ smoking. Journal of Health and Social Behavior, 47, 32– 46. http://dx.doi.org/ 10.1177/002214650604700103 Menning, C. L., & Stewart, S. D. (2008). Nonresident father involvement, social class, and adolescent weight. Journal of Family Issues, 29, 1673–1700. http://dx.doi.org/10.1177/0192513X08322930 Murphey, D., Stratford, B., Gooze, R., Bringewatt, E., Cooper, P. M., Carney, R., & Rojas, A. (2014). Are the children well? A model and recommendations for promoting the mental wellness of the nation’s young people Child Trends. Princeton, NJ: Robert Wood Johnson Foundation. Phares, V., & Compas, B. E. (1992). The role of fathers in child and adolescent psychopathology: Make room for daddy. Psychological Bulletin, 111, 387– 412. http://dx.doi.org/10.1037/00332909.111.3.387 Robertson, E. R., David, S. L., & Rao, S. A. (2003). Preventing drug use among children and adolescents. Bethesda, MD: U. S. Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse. Solomon-Fears, C. (2014). Fatherhood initiatives: Connecting fathers to their children. Hauppauge, NY: Nova. StataCorp. (2013). Stata statistical software: Release 13 (Version 13) [Computer software]. College Station, TX: StataCorp LP. Stewart, S. D., & Menning, C. L. (2009). Family structure, nonresident father involvement, and adolescent eating patterns. Journal of Adolescent Health, 45, 193–201. http://dx.doi.org/10.1016/j .jadohealth.2009.01.005 Substance Abuse and Mental Health Services Administration. (2013). A day in the life of American adolescents: Substance use facts update. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from http:// www.samhsa.gov/data/2K13/CBHSQ128/sr128typical-day-adolescents-2013.htm U.S. Census Bureau. (2013). Families and living arrangements. Retrieved from http://www.census .gov/hhes/families/data/children.html U.S. Department of Health and Human Services. (2014). The health consequences of smoking—50 years of progress: A report of the surgeon general. Atlanta, GA: U. S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. U.S. Preventive Services Task Force. (2009). Screening and treatment for major depressive disorder in children and adolescents: US Preventive Services Task Force Recommendation Statement. Pediat-
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rics, 123, 1223–1228. http://dx.doi.org/10.1542/ peds.2008-2381 U.S. Preventive Services Task Force. (2013). Child and adolescent recommendations. Rockville, MD: USPSTF Program Office. Vespa, J., Lewis, J. M., & Kreider, R. M. (2013). America’s families and living arrangements: 2012. Washington, DC: U. S. Government Printing Office. Retrieved November, 11, 2013, from http:// www.census.gov/prod/2013pubs/p20-570.pdf Windle, M. (2000). Parental, sibling, and peer influences on adolescent substance use and alcohol
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Received October 1, 2014 Revision received April 10, 2015 Accepted April 15, 2015 䡲
In the public domain http://dx.doi.org/10.1037/fsh0000137
The Influence of Nonresident Fathers on Adolescent and Young Adult Cigarette Smoking Mir M. Ali, PhD and David Dean Jr., PhD Substance Abuse and Mental Health Services Administration, Rockville, Maryland Introduction: In this analysis we examine the relationship between nonresidential father involvement with their children and adolescent smoking behavior using a nationally representative longitudinal dataset. We attempt to determine what influence, if any, nonresident fathers have in the development of this health risk behavior in their adolescent children while accounting for aspects of parenting and family life that have been hypothesized to also influence adolescent cigarette smoking. Method: Data for this analysis come from the first 3 waves of the Longitudinal Study of Adolescent to Adult Health. Given the longitudinal nature of the data, we are able to ascertain whether nonresident father involvement affects adolescent cigarette smoking, an important advance in our understanding of the influence of fathers. Results: We found that greater levels of nonresidential father involvement significantly decrease both the odds of participation in and the intensity of cigarette smoking, especially among girls. This influence is demonstrated not only in adolescence but persists into young adulthood. Discussion: Our findings underscore the importance of adolescents’ living arrangements and the role that nonresident fathers might play in influencing adolescent cigarette smoking, a health risk behavior of strong public health significance. Fathers make important contributions to the health and wellbeing of their children, and interventions focused on nonresident fathers in particular would likely be of significant help to the substance abuse prevention field. Interventions to support father involvement, particularly of nonresident fathers, with their children should be implemented as a preventive strategy to reduce the likelihood of adolescent cigarette smoking. Keywords: adolescence, cigarette smoking, fathers, young adulthood
In the last 40 years, the nature of marriage and family in the United States has changed statistically significantly, with married couples accounting for about 70% of households in 1970 to only 49% of households in 2012 (Vespa, Lewis, & Kreider, 2013). About 60% of households with children under 18 years old in 2012 consisted of a married couple, and of those a considerable proportion (15%) were made up of at least one nonbiological (i.e., step-parent)
This article was published Online First June 1, 2015. Mir M. Ali, PhD and David Dean Jr., PhD, Analysis and Services Research Branch, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Correspondence concerning this article should be addressed to David Dean Jr., PhD, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD 20857. Email: [email protected]
parent (U.S. Census Bureau, 2013). Although a majority of fathers reside with their children under 18, about one-quarter have at least one child who does not physically reside with him (Jones & Mosher, 2013). Adolescents are living in what has historically been identified as “nontraditional” families characterized by mothers, often the primary custodial parent, and fathers who no longer reside together. The wellestablished link between parents and their offspring in substance use and abuse requires further investigation to identify risk and protective factors associated with this health risk behavior, particularly the role of nonresident fathers in this increasingly non-nuclear American family (Carr & Springer, 2010; Windle, 2000). Given the significant public health problem of youth cigarette smoking, in this analysis we focus on the role of nonresident fathers in the development of adolescent smoking using a nationally representative longitudinal dataset to examine the nature of this influence.
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Fathers have increasingly become the focus of developmental and family systems researchers. The historical assumption of little (or only positive) fathers’ influence was evident in most research through the early ’90s, with the important exception being the literature on the children of alcoholics and the lasting effects of a father’s alcohol abuse on their children from adolescence to adulthood. Since that time, researchers have empirically established their influence, particularly relative to the influence of mothers, in psychopathology and substance use in particular (Adamsons & Johnson, 2013; Choi, 2010; Jones & Mosher, 2013; Murphey et al., 2014; Phares & Compas, 1992). Different empirical and theoretical perspectives account for this influence in different ways, such as fathers’ behavioral modeling described by Social Learning Theory or fathers as a source of values or attitudes in social– cognitive models like the Theory of Planned Behavior (Bandura, 1977; Fishbein & Ajzen, 2011). The analyses described here reflect these empirical and theoretical perspectives through the integrative framework described by “life-course health development” that attempts to describe contextual influences on individual behavior and account for the role of systems in which development occurs (Halfon & Hochstein, 2002). Public policies adopted by the federal government, such as the “responsible fatherhood” initiatives begun during the Bush administration and continued by the Obama administration, reflect the growing understanding of the important role of fathers, beyond their financial contributions, in the positive development of children and prevention of deleterious adolescent behaviors (Solomon-Fears, 2014). Adolescent smoking continues to be a significant public health issue as it is one of the top four substances abused by adolescents (Substance Abuse and Mental Health Services Administration, 2013). The well-documented short-term and long-term health consequences of adolescent cigarette smoking can be compounded by its association with other, cooccurring behavioral issues. It also disproportionately affects vulnerable populations, such as those of low socioeconomic status (SES), some ethnic minority groups, and lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth (Lee, Griffin, & Melvin, 2009; U.S. Department of Health & Human Services, 2014).
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Cigarette smoking behavior typically becomes established in adolescence, and is, therefore, a prime candidate for prevention efforts during this developmental period. Indeed, many researchers and policy advocates have emphasized the importance of focusing prevention and treatment resources on adolescents in order to improve their, and the population’s, long-term health (Bruvold, 1993). Because of their role as models and social supporters, parents and families are frequent targets of research on influential factors in adolescent cigarette smoking as well as effective preventive interventions (Lantz et al., 2000; Mendez, Ogg, Loker, & Fefer, 2013; Menning, 2006; Robertson, David, & Rao, 2003; U.S. Department of Health & Human Services, 2014). Researchers have investigated the characteristics of families, such as structures (of the residential and/or biological family), transitions (in parental relationships and residence), and processes (e.g., parental behaviors, economic hardship), that are associated with child health and well-being (Carr & Springer, 2010). In this analysis, we focus on a large subset of “disrupted” families in the National Longitudinal Study of Adolescent to Adult Health and investigate the role of nonresident fathers in adolescent cigarette smoking. Using family data, we attempt to determine what influence, if any, nonresident fathers have in the development of this health risk behavior in their adolescent children while accounting for aspects of parenting and family life that have been hypothesized to also influence adolescent cigarette smoking. Given the longitudinal nature of the data, we are able to ascertain whether nonresident father involvement affects adolescent cigarette smoking, an important advance in our understanding of the influence of fathers (Hawkins, Amato, & King, 2007). Method Data Source and Analysis Sample The data for this study come from the National Longitudinal Study of Adolescent to Adult Health (henceforth “Add Health”). Add Health is a longitudinal survey of U.S. adolescents in 132 schools nationwide enrolled in Grades 7 to 12 in 1994 –1995 (Wave I), with follow-up surveys in 1996 (Wave II), 2001–
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2002 (Wave III), and 2007–2008 (Wave IV) (Harris et al., 2009). Add Health was initially approved by the institutional review board at the University of North Carolina–Carolina Population Center (Chapel Hill, North Carolina). A unique feature of Add Health is that it collects extensive information on not only adolescents’ smoking behavior but also characteristics of their relationship with their nonresident father and aspects of parental involvement with their respondent children. To that end, Add Health interviewed one of the parents (mostly mothers) of each respondent as part of the survey in 1994. This parent survey is our primary source for measuring family characteristics such as family structure and household financial information, such as whether the nonresident father pays child support and whether the primary caregiver was on welfare. Also, the longitudinal nature of the data allows us to examine the long-term relationship between nonresident father involvement and adolescent smoking. The data for our analysis come from the first three waves of the survey. The sample for our analysis includes all individuals less than 18 years of age in Wave II who were interviewed in all of the first three waves of the study, with nonmissing information for one or more of the variables used in our analysis, who had a nonresident biological father but were living with their biological mothers, and was a nonsmoker in Wave I (N ⫽ 3,100). Table 1 reports summary statistics for the outcome measures and all control variables used in our analysis. Measures In our analysis we focus on both current cigarette use, with the question, “During the past 30 days, on how many days did you smoke cigarettes?” (dichotomized to none or 1⫹) and the intensity of use, with the questions, “During the past 30 days, on how many days did you smoke cigarettes?” and “During the past 30 days, on the days you smoked, how many cigarettes did you smoke each day?” For current use, we thus have a binary variable reflecting cigarette use. For intensity, we multiplied the responses to both questions to generate a continuous variable and further transformed it using the natural log of the positive values for those responses to be able to interpret the coefficients of explanatory variables as elasticities.
The key independent variable of interest is the nonresident fathers’ involvement with the adolescents. Following Menning and Stewart (2008) and Stewart and Menning (2009), the measure of nonresident father involvement was constructed using 11 indicators present in Wave I of the survey (Cronbach’s alpha ⫽ .80). Adolescents were asked how close they were to their nonresident fathers, ranging from 1 (not close at all) to 5 (extremely close), how often they had stayed overnight with him during the past year, from 0 (not at all) to 5 (more than once a week), and a series of nine questions about whether they had participated in various activities such as going shopping, going to a movie, or working on a project for school with their nonresident father (1 ⫽ yes, 0 ⫽ no). These measures were then summed and standardized (to have a mean of 0 and a standard deviation of 1) to create a measure of nonresident father involvement (Menning & Stewart, 2008; Stewart & Menning, 2009). Other measures related to nonresident fathers include an indicator for whether the nonresident father was a smoker or not, his level of education (less than high school, high school, some college, or college graduate), and whether he paid monthly child support (Amato & Gilbreth, 1999; Cheadle, Amato, & King, 2010; King & Sobolewski, 2006; Menning, 2006). Because our sample is restricted to those who lived with their biological mothers, we account for the household family structure of the adolescent by the presence (or absence) of another man in the household: living with biological mother and a nonbiological father, living with biological mother and mother’s unmarried partner, or living with biological mother only. Because Add Health interviewed one of the parents (mothers in the case of this analysis), we were also able to control for a number of biological mother’s characteristics including whether the mother had a college degree, whether the mother received welfare, whether the mother is a smoker, and whether the mother lives in the current location because of the school district. Other controls in our model include whether the adolescents have easy access to cigarettes in their home, percentage of their classmates who are smokers, whether they are religious, their selfrated health and demographic characteristics such as age, gender, race, and whether they were born in the United States.
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Table 1 Descriptive Statistics Variables Dependent variable Cigarette use Intensity (natural log) Cigarette use Intensity (natural log) Nonresident father characteristics Involvement scale (standardized) Smoker College Child support Demographic characteristics Male Age Race White Black Hispanic Other Grade Seven Eight Nine Ten Eleven Twelve Family structure Born USA Religious Ease of cigarettes availability Self-rated good health Classmates smoke Age Education Currently married Self-rated good health Religious Mother characteristics College Received welfare Smoker N
Wave
Mean
Standard deviation
Min
Max
II II III III
0.51 3.81 0.34 5.22
0.49 2.21 0.47 1.54
0 0 0 0
1 7.50 1 10.31
I I I I
0.00 0.67 0.05 0.55
1.00 0.47 0.22 0.50
⫺1.50 0 0 0
2.72 1 1 1
II II II
0.34 15.18
0.47 1.45
0 12
1 17
0.49 0.33 0.14 0.04
0.50 0.45 0.35 0.20
0 0 0 0
1 1 1 1
0.09 0.11 0.14 0.20 0.22 0.21 1.76 0.82 0.54 0.26 0.71 0.54 22.03 2.28 0.17 0.94 0.51
0.09 0.32 0.31 0.34 0.36 0.34 0.56 0.38 0.50 0.44 0.46 0.15 1.79 0.73 0.38 0.22 0.50
0 0 0 0 0 0 1 0 0 0 0 0 18 1 0 0 0
1 1 1 1 1 1 3 1 1 1 1 1 27 3 1 1 1
0.22 0.29 0.36
0.41 0.45 0.48
0 0 0
1 1 1
II
II II II II II I III III III III III I I I
Analysis Plan For our binary indicator of smoking (cigarette use) we estimated a logistic regression model and for our continuous measure of smoking (intensity) we estimated an ordinary least square regression (OLS) for those who are smokers using StataSE 13 (StataCorp, 2013). Regression estimates of the effect of the relationship with nonresident father on smoking behavior may be subject to bias from at least
3,100
two sources, both of which we attempted to address empirically. First, common unobserved environmental factors may confound the effect of the nonresidential father involvement on cigarette use. These could include factors such as cigarette prices/taxes, a lower opportunity cost of engaging in smoking attributable to ease of availability, the percentage of the population in poverty, and so on. These could also include school size, region, economic and sociocultural factors. Second, the estimated effect of the re-
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lationship with nonresident father may be due to reverse causality or simultaneity. For example, it could be that adolescents who are more prone to smoking are also less likely to have a good relationship with their nonresident father. If either of these problems is present, the regression estimator will be inconsistent and will not have a causal interpretation. We try to address these potential problems using the following empirical strategies. First, our longitudinal data allow us to use a lagged measure of the nonresident father involvement. This strategy would address the problem of reverse causality assuming smoking in period t cannot influence the adolescent’s relationship with their nonresident father in period t ⫺ 1. Thus, in our case adolescent smoking indicators are drawn from Wave II and Wave III of the Add Health survey and the relationship with nonresident father is drawn from Wave I. Also, as noted previously, our analysis sample consists of adolescents who were not smokers in Wave I, which further allows us to avoid any remaining confounding factors related to reverse causality. In addition, the longitudinal nature of our data allows us to estimate both the short-term and long-term effect of nonresident father involvement on smoking—something that was not done in prior studies. Second, we address unobserved school-level confounders by introducing a vector of school-specific dummy variables in our model. These schoollevel fixed effects will account for any common environmental characteristics at the school level that may be correlated with both nonresident father involvement and smoking. For example, an adolescent who attends a school where poverty rates and crime are high, access to cigarettes is easy, and public recreational facilities are scarce may be more likely to smoke and also less likely to engage in activities with their nonresident father. Results Table 2 presents our estimates of the effect of nonresidential father involvement in Wave I (1994 –1995) on smoking behaviors in 1996 (Wave II), with the second column containing logistic estimates (odds ratio) on use and column four reporting the estimates from OLS regression on intensity, after accounting for the Add Health complex survey design. The coef-
ficients of the intensity model represent elasticity since our consumption measure is in natural log form, that is, a coefficient times 100% is approximately equal to the percentage change in the number of cigarettes smoked for one unit change in the independent variable. These models have been estimated using the lagged (Wave I) measure of nonresident father involvement and control for school-level fixed effects. The estimates show an inverse relationship between nonresidential father involvement and smoking. More specifically, a one–standard deviation increase in nonresident father involvement is associated with a 14% decline in the odds of an adolescent becoming a smoker and a 2.5% reduction in the number of cigarettes smoked by an adolescent smoker during the past month. The estimates on easy access to cigarettes and nonresidential father smoking reflect the expected relationship— easy access to cigarettes and nonresidential father smoking are both positively correlated with smoking. Other control variables, such as demographic characteristics and parental measures, also reflect the expected relationships. After stratifying the estimates by gender (see Table 3), the effect of nonresident father involvement on smoking participation appears to be approximately the same for both adolescent girls and boys. However, for the intensity measure the estimates appear slightly larger for girls, for whom the reduction in smoking intensity is approximately 3.1% compared with a reduction of 1.1% for boys, a difference that was not statistically significant. Because the estimates of the control variables exhibit a pattern similar to the results in Table 2, we only report the results for the measure of nonresidential father involvement. Table 4 presents estimates with smoking behaviors measured in 2002 (when most of the adolescents have made the transition to young adulthood) and the nonresident father involvement measured in 1994 –1995. The results suggest that the level of nonresidential father involvement from adolescence continues to be associated with smoking participation even after the adolescents makes the transition into young adulthood. In particular, the results show that a one–standard deviation increase in nonresident father involvement is associated with a 13% decline in the odds of the individual being a smoker. However, the effect on number of
NONRESIDENT FATHERS AND YOUTH CIGARETTE SMOKING
319
Table 2 Effect of Wave I (1994 –1995) Nonresident Father Involvement on Wave II (1996) Smoking Cigarette use Variables Nonresident father characteristics Involvement scale (standardized) Smoker College Child support Demographic characteristics Male Age Race White Black Hispanic Grade Seven Eight Nine Ten Eleven Twelve Six (reference category) Family structure Born USA Religious Ease of cigarettes availability Self-rated good health Classmates smoke Mother characteristics College Received welfare Smoker Adjusted R2 N ⴱ
p ⬍ .1.
ⴱⴱ
p ⬍ .05.
ⴱⴱⴱ
Intensity
Odds ratio
95% confidence interval
Coefficient
Standard error
0.86ⴱⴱⴱ 1.16 0.92 0.97
0.78, 0.96 0.97, 1.51 0.83, 1.03 0.78, 1.19
⫺0.25ⴱⴱⴱ 0.27 0.18 ⫺0.31ⴱⴱ
0.08 0.17 0.21 0.15
1.12 0.96
0.92, 1.37 0.84, 1.09
0.15 0.20ⴱⴱ
0.14 0.09
1.20 0.37ⴱⴱⴱ 1.50
0.67, 2.14 0.21, 0.68 0.78, 2.88
0.68 ⫺0.96ⴱⴱ 0.32
0.48 0.48 0.53
0.54 0.31ⴱⴱⴱ 0.36ⴱⴱⴱ 0.45ⴱⴱⴱ 0.41ⴱⴱⴱ 0.61ⴱⴱⴱ
0.18, 1.63 0.17, 0.60 0.21, 0.64 0.29, 0.70 0.28, 0.60 0.42, 0.88
⫺0.08 0.06 ⫺0.20 0.25 ⫺0.06 ⫺0.33
0.75 0.43 0.37 0.29 0.25 0.24
1.03 0.92 0.73ⴱⴱⴱ 1.84ⴱⴱⴱ 0.83 1.13
0.87, 1.22 0.70, 1.22 0.60, 0.90 1.50, 2.25 0.56, 1.23 0.97, 1.31
0.15 0.21 ⫺0.52ⴱⴱⴱ 0.70ⴱⴱⴱ ⫺0.75ⴱⴱⴱ ⫺0.01
0.12 0.20 0.16 0.15 0.26 0.09
0.92 1.13 1.14
0.71, 1.19 0.90, 1.42 0.93, 1.41
⫺0.46ⴱⴱ 0.33ⴱ 0.19
0.20 0.17 0.16
0.158 3,100
0.285 1,500
p ⬍ .01.
cigarettes smokes (intensity) is not statistically significant. After stratifying the estimates by gender, the effect continues to be larger for young women. Discussion In this analysis we used a nationally representative survey of adolescents to examine the relationship between nonresident father involvement and smoking behavior. Utilizing the longitudinal characteristics of the data enabled us to address the potential reverse causality in the relationship between nonresident father involvement and adolescent smoking, and the use of school fixed effects allowed for the control of many unobservable potential confounders at the
school and community level. In addition, the longitudinal aspect of the data also allowed us to estimate both the long-term and short-term impact of nonresidential father involvement. We find that greater levels of nonresidential father involvement significantly decrease both the odds of participation in and the intensity of cigarette smoking, especially among girls. This influence is demonstrated not only in adolescence but persists into young adulthood. Although it is beyond the scope of our analysis to investigate why this effect appears to be larger for girls, we suspect that the different ways in which boys and girls continue to be socialized, as well as differing expectations regarding their activities and relationships with mothers and fathers, may account for this difference (Lytton
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Table 3 Effect of Wave I (1994 –1995) Nonresident Father Involvement on Wave II (1996) Smoking: Stratified by Gender Smoker Variables
Odds ratio
Males Involvement scale (standardized) N Females Involvement scale (standardized) N ⴱ
p ⬍ .1.
ⴱⴱ
p ⬍ .05.
ⴱⴱⴱ
95% confidence interval
0.86ⴱⴱ
0.73, 0.99
Number of cigarettes smoked Coefficient ⫺0.11
1,054 0.85ⴱⴱ
Standard error 0.13 495
0.73, 0.99
⫺0.34ⴱⴱⴱ
2,046
0.12 1,005
p ⬍ .01.
& Romney, 1991; Witt, 1997). In addition, recent literature has also shown differential effects by gender in adolescent smoking-related outcomes (Ali, Amialchuk, & Heller, 2015). Although this is an important contribution to the fatherhood and substance abuse prevention literature, we should acknowledge several caveats relevant to this analysis. Our model is limited, of course, to the variables measured in the Add Health study; we were not able to account for all of the potential confounders of the relationship between nonresident father involvement and adolescent cigarette use. For instance, we were unable to capture aspects of the diversity of nonresident father families, such as the range of family living and custodial arrangements as well as remarriage and blended family effects. We were unable to account for whether fathers were ever present in the family home or moved out at a particular time in their child’s life. The timing of life transitions, such as parental divorce, is an important factor in the lives
of children that has been linked to substance use initiation and escalation of use (Carr & Springer, 2010). Despite these limitations, we identify several strengths of these analyses that we believe add to the literature, particularly aspects of the study design that that have been called for by researchers in this topic (Carr & Springer, 2010) and extends progress in it (Menning, 2006). First, our use of the nationally representative Add Health dataset permits us to make wellsupported generalizations regarding U.S. youth. The longitudinal nature of the data allows us to interpret the association between father involvement at Wave I as having a causal effect on adolescent behavior at Wave II and young adult behavior at Wave III. This assessment demonstrates both the short- and long-term effects of nonresident father involvement, another advance for the literature. Also, studies in family systems are sometimes criticized for a focus on individuals rather than actual family dynamics,
Table 4 Effect of Wave I (1994 –1995) Nonresident Father Involvement on Wave III (2002) Smoking Smoker Variables
Odds ratio
Full sample Involvement scale (standardized) N Males Involvement scale (standardized) N Females Involvement scale (standardized) N ⴱ
p ⬍ .1.
ⴱⴱ
p ⬍ .05.
ⴱⴱⴱ
p ⬍ .01.
Number of cigarettes smoked
Confidence interval
Coefficient
0.79, 0.96
⫺0.08
0.87ⴱⴱⴱ 3,100 0.92
0.79, 1.05
⫺0.14
0.08 338
0.72, 0.95 2046
0.06 1,300
1054 0.83ⴱⴱⴱ
Standard error
⫺0.04
0.08 962
NONRESIDENT FATHERS AND YOUTH CIGARETTE SMOKING
and we have been able to perform, essentially, a dyadic, family-level analysis. In this case, too, the individual family member is the informant, rather than having the parent as an informant on child behavior, which is a strong indicator of the validity and reliability of the reported variables. Finally, in our analysis we were able to account not only for whether nonresident father influence exists for cigarette smoking in children but also on the nature of that influence (through involvement) and various other family and community characteristics. These findings suggest that the effects of growing up with a nonresident father persist from adolescence through young adulthood and affect an adolescent risk behavior of strong public health significance. For at least the last two decades, researchers have been investigating the influence of fathers in the development and well-being of children in depth that had previously been focused on the influence of mothers (Adamsons & Johnson, 2013; Amato & Gilbreth, 1999; Phares & Compas, 1992). Mothers had arguably received a great deal of the credit and blame for both positive and negative outcomes for their children, whereas fathers were regarded as relatively benign actors whose influence was assumed to be largely positive, if it existed (Adamsons & Johnson, 2013). Our findings demonstrate the important contributions fathers make to the health and wellbeing of their children, a result increasingly evident in the research literature on fatherhood, and suggest that interventions focused on nonresident fathers in particular would likely be of significant help to the substance abuse prevention field. It is clear that interventions to foster father involvement, particularly of nonresident fathers, with their children should be implemented as a preventive strategy to reduce the likelihood of adolescent cigarette smoking. Efforts such as the federal “responsible fatherhood” initiatives could address the unique circumstances of nonresident fathers in establishing and maintaining positive, quality relationships with the children, an important goal supported by governmental and nongovernmental policy recommendations and efforts (Murphey et al., 2014; Solomon-Fears, 2014). Such efforts should continue to target at-risk families identified to have parents in need of skills-based interventions to foster better involvement as well as monitoring and other spe-
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cific parenting practices that ensure positive youth outcomes. Clinicians should be aware of the role of both resident and nonresident fathers, particularly given the historical assumption of the neutral or solely positive impact of fathers. Resources such as the AMA Guide for Adolescent Preventive Services and the recommendations of the US Preventive Services Task Force reflect the need for clinicians and other care providers to recognize the importance of families, particularly parents, and engaging them in their efforts to prevent problem behavior and raise healthy children (American Medical Association, 1997; Knishkowy & Palti, 1997; U.S. Preventive Services Task Force, 2009, 2013). Future research should continue to address the nature of good parenting practices as well as the impact of such practices on other substances of abuse in adolescence.
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Received October 1, 2014 Revision received April 10, 2015 Accepted April 15, 2015 䡲
