Parental divorce and adolescent cigarette smoking and alcohol use: assessing the importance of family conflict

Aim: To investigate how family conflict contributes to the relationship between parental divorce and adolescent cigarette smoking and alcohol use. Design: Population-based cross-sectional survey. Setting: School classrooms in Iceland in which an anonymous questionnaire was administered to respondents by supervising teachers. Participants were 7430 (81.4%) of 9124 14- to 16-year-old adolescents. Main outcome measure: Cigarette smoking and alcohol use during the last 30 days were assessed by self-report. Results: Parental divorce was related to adolescent cigarette smoking during the last 30 days (OR = 2.12, 95% CI 1.84-2.44) when controlling for gender only, but was insignificant (OR = 1.18 95%, CI 0.99-1.44) when controlling for relationship with parents, disruptive social changes and family conflict. There was a significant relationship between parental divorce and adolescent alcohol use during last 30 days (OR = 1.66, 95% CI 1.48-1.87), controlling only for gender; however, the relationship disappeared (OR = 1.04, 95% CI 0.91-1.20) when controlling for other variables. Conclusion: Family conflicts are important contributors to the relationship between parental divorce and adolescent cigarette smoking and alcohol use. Conflict between parents and adolescents, but not inter-parental conflict, appears to be the most important factor in the relationship between family conflict and adolescent substance use.