Parental permissiveness and teen vaping: Effects of allowing alcohol and tobacco in Spanish families

Abstract Background Vaping among adolescents has increased in recent years, raising significant public health concerns due to the addictive nature of nicotine and associated long-term health risks. While the role of peer influence and socioeconomic status has been extensively studied, less is known about how parental permissiveness toward legal substances such as alcohol and tobacco influence vaping uptake. This study investigates the relationship between parental approval of alcohol and tobacco use and adolescent vaping in Spain, aiming to inform more effective prevention strategies. Methods We used data from the 2021 Spanish School Survey on Drug Use (ESTUDES), a nationally representative sample of over 22,000 students aged 14-18. Multilevel logistic regressions were applied to examine the association between parental permissiveness-distinguishing between mothers, fathers, or both-and the likelihood of vaping in the past month, past year, and ever in lifetime. Models controlled for sociodemographic variables, socioeconomic status, smoking exposure in the household and school, and perceived risks of vaping. Results Teens whose parents jointly allowed tobacco use were 110% more likely to vape in the past month (OR = 2.10; 95% CI: 1.58-2.79), while those permitted to consume alcohol were 56% more likely (OR = 1.56; 95% CI: 1.23-1.97). Maternal permissiveness showed a stronger association than paternal. The relationship held across longer timeframes and was more pronounced in households where mothers held higher education or were the sole earners. Around 11% of variance in vaping was attributable to school-level factors and 2% to province-level variation. Conclusions Parental permissiveness is a key predictor of adolescent vaping. Public health interventions should target families, promoting stricter household norms on alcohol and tobacco. Engaging parents, particularly mothers, in prevention strategies may reduce early nicotine use and its long-term health consequences. Key messages • Parental permissiveness toward alcohol and tobacco significantly increases the likelihood of adolescent vaping, especially when both parents are tolerant or when mothers are permissive. • Family-based prevention strategies that address parental attitudes are essential to curb early vaping initiation and reduce long-term health risks among youth.