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Stop Smoking’s Family Ties: What to Do When a Child’s Sibling Smokes

​​​​By: Carol Duh-Leong, MD, MPP

Parents are usually thrilled when their children learn to share with each other—whether its toys when they're younger or the family car when they're teens. One thing siblings shouldn't share is life-threatening habit like smoking or tobacco use.

A study published in Pediatrics showed teens in particular may be more likely to begin smoking if they have an older sibling or a sibling of the same gender that smokes. Teens' behaviors are shaped by the actions of people important to them. Regardless of normal sibling bickering growing up, a child's brother or sister also has an important influence on his or her decisions.

If your teen has siblings or other family members who smoke, take steps to help protect him or her from an addiction to nicotine in tobacco:

  • Look in the mirror. As a parent, your smoking behavior has an enormous influence on your teen's behavior. It may not feel like it every day, but your teen looks up to you as a role model, and one of the best ways to prevent your teen from smoking is to model smoke-free behavior yourself. If you smoke, quit. There are free resources including your state's quitline to help.

  • Discuss smoking with your teen. Teens value the opinions of their parents. Talk to your child about smoking-related issues in a constructive and respectful manner so both of you can express your feelings and opinions freely. This also opens the door to a relationship where your teen sees you as a person to talk to about difficult issues.

  • Identify your teen's talents. Smoking is more common among teens with lower grade-point averages and with lower self-esteem. Be very positive about their child's talents and goals—whether it be basketball, social studies, or tuba— so that he or she has a strong sense of identity outside of potentially unhealthy habits.

  • Tell your children about the side effects of smoking. Explain that smoking hurts athletic ability, causes early wrinkles, stinky breath, stained teeth, and costs a lot of money. Not to mention that, according to the Centers for Disease Control and Prevention, people who smoke die at least a dozen years sooner than nonsmokers on average. Teens concerned about the environment might also be interested to know that more than a billion and a half pounds of cigarette butts end up as toxic trash each year!

  • Encourage the sibling to quit. Talk to your teen's sibling about his or her role in influencing smoking habits in their sibling(s). Empower your son or daughter to be a positive role model for his or her siblings by quitting smoking. Ask their pediatrician for help to encourage and provide resources for him or her to quit.

  • If your other child does start to smoke, encourage him or her to quit. Nicotine addiction takes hold quickly—within days or weeks after starting to smoke. It isn't easy, but every attempt should be considered a success.

  • Think beyond cigarettes. Smokeless tobacco, hookah, e-cigarettes, and cloves are increasingly popular among teens. All are addictive and can cause health problems.

Parents have the power:

Bottom Line—Kids who have a sibling who smoke are more likely to smoke. However, you can prevent smoking in your child by modeling smoke-free behavior, having open and honest discussions, and supporting or encouraging your other child to quit.

Additional Information from


About Dr. Duh-Leong:

Carol Duh-Leong, MD, MPP, is Chief Resident in Social Pediatrics at Children's Hospital at Montefiore in New York. Within the American Academy of Pediatrics (AAP), she is a member of the Section on Pediatric Trainees (SOPT). Follow her on Twitter @leongisland. ​

Last Updated
Section on Tobacco Control (Copyright © 2017 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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