Association Between Parental Smoking Status and Adolescent Mental Health: Population-Based Study.

Background: Adolescents' mental health problems significantly affect their long-term psychological and physical health. Although peer influence grows during adolescence, parental influence remains critical. Parental smoking is associated with behavioral problems in adolescents. Objective: This study aimed to investigate the association between parental smoking, particularly maternal smoking, and adolescents' mental health outcomes in South Korea, as research in this area is limited. Methods: We analyzed data from the nationwide Korea National Health and Nutrition Examination Survey from 2012 to 2017. A total of 2761 adolescents were included in the final analysis after excluding those with missing data. We used ANOVA and chi-square tests to compare adolescents' and parents' baseline characteristics and mental health. In addition, multiple logistic regression analyses were conducted to examine the association between parental smoking status and adolescents' mental health. Results: Our logistic regression analyses revealed that mothers' current smoking habits were significantly associated with their adolescents' cognitive stress (odds ratio [OR] 1.65, 95% CI 1.06-2.56), experiences of melancholy (OR 2.09, 95% CI 1.20-3.65), and suicidal ideation (OR 2.39, 95% CI 1.17-4.88). Furthermore, adolescents whose mothers were current smokers and had cognitive stress demonstrated higher cognitive stress (OR 2.09, 95% CI 1.12-3.90), melancholy (OR 2.27, 95% CI 1.10-4.71), and suicidal ideation (OR 2.74, 95% CI 1.21-6.23) than those whose mothers were not smokers and had no cognitive stress. Conclusions: Efforts to improve adolescents' mental health require considering their mothers' smoking status and stress levels. This highlights the need to develop programs to enhance adolescent mental health, manage maternal stress, and promote smoking cessation.