Timing of Family Adversity During Adolescence and its Impact on Alcohol and Tobacco Initiation: A Longitudinal Study Among Taiwanese Adolescents


We examined the impact of time-varying exposure to family adversity, including parental conflict, parental absence from home, divorce, and parental death, on the timing of drinking and smoking initiation among Taiwanese youth between ages 14 and 22 years. We used six waves of data from a longitudinal panel study conducted in northern Taiwan between 2001 and 2009, and included 5446 students. The analysis demonstrated that exposure to parental conflict, divorce, and parental death increased the risk of drinking and smoking initiation. The odds ratios (OR) for smoking and drinking initiation among youth experiencing conflict between parents were 1.33 (95% CI 1.10–1.73) for smoking and 2.00 (1.26–3.20) for drinking. The OR for parental death were 2.96 (1.69–5.18) for smoking and 8.07 (1.79–36.49) for drinking. The association becomes more pronounced at age 18 (i.e., the legal age for drinking and smoking in Taiwan), and lasts until early adulthood.

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We would like to thank the researchers, participants, and staff of the Taiwan Youth Project, conducted by Academia Sinica in Taiwan, for their valuable contributions. We gratefully acknowledge Dr. Chin-Chun Yi for the instruction to the project.

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Drs. Hsu and Kawachi had full access to all of the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Yu-Tien Hsu.

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Hsu, Y., Kawachi, I. Timing of Family Adversity During Adolescence and its Impact on Alcohol and Tobacco Initiation: A Longitudinal Study Among Taiwanese Adolescents. Child Psychiatry Hum Dev 50, 257–267 (2019). https://doi.org/10.1007/s10578-018-0838-0

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  • Family adversity
  • Family structure
  • Adolescence
  • Substance use
  • Asian