Family Harmony as a Protective Factor Against Adolescent Tobacco and Alcohol Use in Wuhan, China

Abstract

Purpose. To investigate the association between family harmony (FH) and tobacco and alcohol use (TAU) in Chinese adolescents. Methods. Participants completed a survey in 1998 as part of a larger study of adolescent health in Wuhan, China. Analyses were performed on subjects for whom complete data were available (n = 183; 50.8% male; mean age = 13.17 yrs, std dev = 0.59). Structural equation modeling was utilized to quantify the relationships between the FH, TAU, depression, and academic aptitude factors. Results. The conceptualized structural equation model was found to have a good fit to the data (CFI = 0.995; χ² = 39.57, df = 38; p = 40). FH was a significant predictor of TAU (β = −0.42, p<0.05) and was protective. FH' was also negatively related to depression (r = −0.24, p<0.05) and positively related to academic achievement/aptitude (r = 0.35, p<0.05). Conclusions. These central findings highlight the value and importance placed on FH within the Chinese culture. Future prevention programs may benefit by taking into account FH as a potential mediator of TAU in adolescents in China.

• Adolescence
• Tobacco
• Alcohol
• Family
• China
• Family harmony

Resumen

Propósito. Investigar la asociación entre Armonía Familiar (AF) y el uso de tabaco y alcohol en adolescentes de raza China. Método. Los participantes completaron una encuesta como parte de un estudio extenso sobre la salud de los adolescentes en Wuhan, China. Un análisis fue llevado acabo solo con participantes cuya información estaba completa y disponible (n = 183; 50.8% masculino; edad promedio = 13.17 años, SD = 0.59). El modelaje de ecuación estructural (Structural Equation Modeling) fue utilizado para cuantificar las relaciones entre la AF, el uso de tabaco y alcohol, la depresión y los factores académicos de la aptitud. Resultados. Se encontró que la conceptualizacion del modelo estructural de ecuación (Structural Equation Model) es compatible con los datos estadísticos del estudio (CFI = 0.995; c2 = 39.57, df = 38; p = 0.40). También se demostró que la AF es un elemento que puede predecir el uso de tabaco y alcohol (b = −0.42m, p<0.05) y que por lo tanto puede ser considerado un elemento protector. La AF también se encontró estar negativamente relacionada con la depresión (r = −0.24, p<0.05) y positivamente relacionada con la aptitud y logros académicos (r = 0.35, p<0.05). Conclusión. Estos resultados enfatizan el valor e importancia que la cultura China pone en AF. En el futuro, programas de prevención podrían beneficiarse de tomar en cuenta el papel que juega la AF como un potencial elemento para el uso de tabaco y alcohol.

Résumé

Objet. Investiguer l'association entre l'harmonie familiale (HF) et l'usage de tabac et d'alcool (UTA) parmi les adolescents chinois. Méthodes. Les participants ont rempli un questionnaire qui faisait partie d'une étude sur la santé d'adolescents á Wuhan, Chine. Nous avons analysé les participants qui ont fourni les donnés complètes (n = 183; 50.8% de sexe masculin; âge moyen = 13.17 ± 0.59 ans). Le modèle structural a été utilisé pour quantifier la relation entre l'HF, l'UTA, la dépression, et les facteurs d'aptitude académique. Résultats. Le modèle structural a bien conformé aux donnés (CFI = 0.995 ; X²(38) = 39.57; p = 0.40). Il y a eu une association de protection entre l'HF et l'UTA (r = −0.42, p<0.05). L'HF a été associée négativement avec la dépression (r = 0.24, p<0.05) et positivement avec l'aptitude académique (r = 0.35, p<0.05). Conclusions. Les résultats suggèrent la valeur et l'importance de l'HF dans la culture chinoise. Des programmes de prévention pourraient profiter de la considération de l'HF comme un médiateur de l'UTA parmi les adolescents chinois.

Additional information

Notes on contributors

Dennis R. Trinidad

Dennis R. Trinidad, Ph.D., MPH., received his Ph.D. in Health Behavior Research from the University of Southern California Keck School of Medicine's Institute for Health Promotion and Disease Prevention Research and Transdisciplinary Tobacco Use Research Center. He recently completed his dissertation exploring the link between emotional intelligence and adolescent smoking. His research interests include understanding social and cultural influences on adolescent health risk behaviors, and approaches to prevention of behavioral risks for disease.

Chih-Ping Chou

Chih-Ping Chou, Ph.D., received his Ph.D. in Research Methods and Evaluation, Graduate School of Education, University of California, Los Angeles. He is currently an Associate Professor of Research in the Department of Preventive Medicine at University of Southern California. Dr. Chou has a well-established record on the application and development of statistical models and research methodologies. His major research activities have been in the areas of multivariate statistical analyses, especially structural equation modeling and statistical computing. In addition, he is also actively involved in of substance use prevention and treatment research with extensive experience in the design of community trials, program evaluation, research methodology, and statistical modeling.

Jennifer B. Unger

Jennifer B. Unger, Ph.D., is an Assistant Professor of Preventive Medicine at the University of Southern California Keck School of Medicine. She is an Associate Director of the USC Trans- disciplinary Tobacco Use Research Center (TTURC), an NIH-funded center that studies adolescent smoking prevention across cultures. Dr. Unger's research focuses on the psychosocial and cultural determinants of health behaviors, including acculturation, cultural values, and social integration.

C. Anderson Johnson

C. Anderson Johnson, Ph.D., is the Sidney Garfield Professor of Preventive Medicine at the Keck School of Medicine and Director of the Institute for Health Promotion and Disease Prevention Research. His research focuses on understanding the determinants of health-related lifestyles and approaches to prevention of behavioral risks for disease. His areas of concentration include tobacco, alcohol, and other drug use, nutritional practices and physical exercise, and communication strategies for health promotion. Dr. Johnson is Principal Investigator for “Lowering Smoking and Environmental Tobacco Smoke in Pacific Rim Youth,” a program project funded by the Tobacco Related Disease Research Program, and Director of the Transdisciplinary Tobacco Use Research Center funded by the National Cancer Institute, National Institute on Drug Abuse, and the Robert Wood Johnson Foundation. He is also Director of the China Seven Cities Study, a study of health-related lifestyles and approaches to tobacco-use prevention and control in China. Dr. Johnson received his B.A. and Ph.D. in Social Psychology from Duke University.

Yan Li

Yan Li, M.D., is the Vice-Director of the Wuhan Health Bureau in Wuhan, China, a large metropolitan city of over 7 million people and capital of the Hubei Province in central China. She served as the former Director and Chief-Doctor of the Wuhan Public Health and Anti-epidemic Station prior to taking her current position. Dr. Li is a Co-Principal Investigator of a cohort study of adolescent health promotion and smoking prevention in Wuhan (the Wuhan PAS/USC Collaboration Project), as well as a Co-Principal Investigator of the University of Southern California Transdisciplinary Use Research Center (TTURC).