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Mental & Physical Health20256 min read

How Your Childhood Shapes Your Smoking Habits

A cross-national analysis of childhood predictors of daily smoking in adulthood

Notable finding

Parental divorce predicted higher adult smoking risk in all 22 countries studied

By
Jang, Sung Joon et al.
Participants
202,898
Countries
22
Journal
Communications Medicine
DOI
10.1038/s43856-025-01005-3
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§1

Key Takeaways

01

In a pooled analysis across 22 countries, prosocial childhood experiences such as good parental relationships and religious service attendance were associated with a lower likelihood of daily smoking in adulthood, while adverse experiences like parental divorce, abuse, and poor health were associated with a higher likelihood.

02

The direction and strength of associations between childhood predictors and adult daily smoking tended to be consistent between binary and continuous measures of smoking and between total and smoker samples, though effect sizes varied across countries.

03

The estimated effects of childhood predictors on adult daily smoking were moderately robust against potential unmeasured confounding, though some associations would require only weak unmeasured confounders to be explained away.

§2

Why It Matters

Creating safe and stable environments for children is a powerful, and often overlooked, tool for preventing smoking.

This research matters because it shows that childhood experiences — not just adult circumstances — are connected to one of the world's leading preventable causes of disease and death. Most prior studies on smoking predictors were done in Western countries and only looked at whether people smoke, not how much. By examining both across 22 diverse nations, this study reveals that certain childhood experiences — warm parent relationships, religious community involvement, and freedom from abuse — tend to accompany lower smoking rates across very different cultures. Meanwhile, adversity like parental divorce, abuse, and family exclusion tend to accompany higher rates. For public health, this means anti-smoking efforts shouldn't focus only on adult behavior. Supporting families, addressing childhood trauma, and strengthening parent-child bonds may be part of a longer-term strategy to reduce tobacco use worldwide. The findings also highlight that country-specific contexts matter — what works in one nation may look different in another.

This research matters because it shows that childhood experiences — not just adult circumstances — are connected to one of the world's leading preventable causes of disease and death. Most prior studies on smoking predictors were done in Western countries and only looked at whether people smoke, not how much. By examining both across 22 diverse nations, this study reveals that certain childhood experiences — warm parent relationships, religious community involvement, and freedom from abuse — tend to accompany lower smoking rates across very different cultures. Meanwhile, adversity like parental divorce, abuse, and family exclusion tend to accompany higher rates. For public health, this means anti-smoking efforts shouldn't focus only on adult behavior. Supporting families, addressing childhood trauma, and strengthening parent-child bonds may be part of a longer-term strategy to reduce tobacco use worldwide. The findings also highlight that country-specific contexts matter — what works in one nation may look different in another.

Creating safe and stable environments for children is a powerful, and often overlooked, tool for preventing smoking.

§3

The Story

Have you ever wondered why some people end up smoking and others don't? This study looked at over 200,000 adults from 22 countries to see if things from childhood — like relationships with parents, family money, religious attendance, and painful experiences — relate to whether someone smokes daily as an adult. The researchers found some clear patterns.

A stable and supportive childhood acts as a powerful shield, protecting against the risk of daily smoking in adulthood.

People who had good relationships with their mother and father growing up were less likely to smoke daily later in life. On the flip side, people whose parents divorced, who experienced abuse, or who felt like an outsider in their own family were more likely to smoke as adults. Poor health in childhood also tended to go along with higher smoking rates. Interestingly, kids who attended religious services at least once a week were slightly less likely to smoke later, and among those who did become smokers, they smoked fewer cigarettes per day.

Being born in another country was also tied to lower smoking rates in most places, though this varied a lot by country. The effects were generally small, and things like age and gender mattered more than any single childhood factor. But the direction of these patterns held up across very different cultures and countries, suggesting that childhood experiences leave a lasting mark on health choices.

Figure
1.26x
Childhood Abuse and Smoking

Individuals who experienced physical or sexual abuse in childhood were, on average, 1.26 times more likely to smoke at least one cigarette daily in adulthood than those who reported no such abuse.

Figure
0.32x
Gender Disparity in Smoking

Females were, on average, 0.32 times as likely to report daily cigarette consumption in adulthood compared to males.

Figure
-1.15 points
Religious Attendance and Smoking Quantity

Daily smokers who attended religious services 1-3 times per month at age 12 reported smoking, on average, 1.15 fewer cigarettes per day than those who never attended.

Figure
53%
Highest National Smoking Prevalence

The prevalence of daily smoking varied widely across the 22 countries studied, ranging from 4.1% in Tanzania to 53% in Türkiye.

Figures
1.26x
Childhood Abuse and Smoking

Individuals who experienced physical or sexual abuse in childhood were, on average, 1.26 times more likely to smoke at least one cigarette daily in adulthood than those who reported no such abuse.

0.32x
Gender Disparity in Smoking

Females were, on average, 0.32 times as likely to report daily cigarette consumption in adulthood compared to males.

-1.15 points
Religious Attendance and Smoking Quantity

Daily smokers who attended religious services 1-3 times per month at age 12 reported smoking, on average, 1.15 fewer cigarettes per day than those who never attended.

53%
Highest National Smoking Prevalence

The prevalence of daily smoking varied widely across the 22 countries studied, ranging from 4.1% in Tanzania to 53% in Türkiye.

§4

Reader Questions

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Research Details
& Citation

Chat with this paper
Published
2025
Journal
Communications Medicine
Participants
202,898
Countries
22
Cite this paper
Jang, S. J., de la Rosa, P. A., Padgett, R. N., Bradshaw, M., VanderWeele, T. J., & Johnson, B. R. (2025). A cross-national analysis of childhood predictors of daily smoking in adulthood. Communications Medicine, 5(1). https://doi.org/10.1038/s43856-025-01005-3
Tags
smokingchildhood-traumaaddictionparentingpublic-healthreligion-spirituality
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