Introduction Studies report various results on association of parental smoking with adolescent smoking initiation. This study researched smoking prevalence among students of the State University of Tetovo in comparison to household smoking; with the aim to establish the association for the given population and, if feasible, initiate subsequent intervention.

Methods Self-reported individual and family smoking was anonymously obtained from the first-year university students of Pharmacy and Dentistry, in year 2009. Prevalence of smoking was analysed in comparison to having smokers within their families, especially parent smokers and sibling smokers. Correlation between the modalities was tested with χ² test and T-test of proportions. Validity scale was set for p<0.01 and p<0.05.

Results 26.7% of respondents (101) were smokers. Generally, the prevalence of smoking was significantly higher among students from smoking households (37.9%) in comparison to students from non-smoking households (11.6%), for p<0.01. Similar behaviour was noticed when smoking prevalence was analysed in comparison to parent smokers (40% vs 16.1%, p<0.05) and sibling smokers (58.3% vs 16.9%, p<0.01). Smoking was prevailing among students whose mothers (66.7%) respectively sisters (61.5%) smoked, in comparison to those whose fathers (58.3) respectively brothers (56.3%) smoked. Gender of smoker was significantly correlated to the gender of family smoker, for each p<0.01.

Conclusion Within the study population, a strong correlation is found between household smoking—particularly maternal smoking—and individual smoking. There is a need of increasing parental especially mothers' awareness and responsibility about the impact of their smoking behaviour on adolescent smoking initiation.