NEWS

Parents who smoke can socialize their children against smoking, study finds

By WENDY TANSON
School of Public Health

CHAPEL HILL -- Parents who smoke and participated in a home-based program to socialize their children against smoking showed success when using at least three of the program’s core educational lessons, said researchers from the University of North Carolina at Chapel Hill School of Public Health.

A report on the study, funded by the National Institute for Child Health and Human Development, appears in the March issue of the journal Tobacco Control.

Lead author Dr. Christine Jackson, associate professor of health behavior and health education at UNC’s School of Public Health, and her colleague Denise Dickinson, a social research associate in the department, conducted a randomized trial to evaluate the effectiveness of "Smoke-free Kids," a voluntary program for smoking parents of 7- and 8-year-old children.

Jackson and Dickinson studied 671 parents and their children during a two-year period. About half of the parents received treatment; the others received fact sheets about youth smoking. Treatment included five core education modules, which gradually increased parents’ skill and comfort levels in communicating with their children about their personal smoking history, addiction and expectations regarding abstinence.

The intervention also included a telephone call from a health educator to provide support and motivation, a toll-free support line for parents, newsletters for parents and children, incentives and a booster educational program delivered to parents after completing the first year of the study.

"Anti-smoking socialization is substantially more than telling children that they should not smoke," said Jackson. "For children, anti-smoking socialization involves internalizing norms in attitude and behavior against smoking initiation, accepting parental monitoring of smoking, and expecting negative consequences for trying smoking and positive consequences for not smoking."

Jackson and Dickinson found that those parents who used at least three of the five core educational modules had significantly greater success in eight of nine categories of anti-smoking socialization than the control group, three months after receiving the treatment components.

In addition, after two years, children of treated parents scored significantly higher than controls on attributes that reduce susceptibility to smoking. They also scored significantly lower than controls on attributes that raise susceptibility to smoking. Children in the control group were 85 percent more likely to intend to smoke in adolescence and twice as likely to have a best friend who had started smoking.

"Given adequate exposure to ‘Smoke-free Kids,’ beneficial effects were observed in households where parents smoke cigarettes," Jackson said. "Parents who had adequate treatment were significantly more likely than controls to believe they could prevent smoking, discuss their smoking history and addiction experience with children, express their negative attitude about children’s involvement with smoking, and communicate with children regarding consequences."

These parents were also more likely to monitor the smoking activity of children and friends and establish social contracts against smoking with their children – shown to be a strong motivational factor for children.

"Particularly noteworthy was the significant increase in parental confidence to prevent their children from smoking," said Jackson. "This result suggests that the program reduced the perceived hypocrisy that occurs when adult smokers contemplate socializing their children against smoking."

Also key, said Jackson, was the sustained impact of the program. "After two years, the program continued to have beneficial effects on children’s susceptibility to smoking," she said. "This provides evidence that children exposed to the program had greater access than controls to a parent who remained motivated to prevent smoking."

The researchers added, however, that results of the study could only be generalized to adult smokers who are receptive to participating in the program, since enrollment in the study was voluntary.

"Further research is now under way to evaluate the program’s potential to lower children’s risk of smoking," said Jackson. "In addition, more work is needed to understand variation by ethnicity in the acceptability and utility of this home-based, self-help approach to smoking prevention."

- 30 -

Note: Jackson can be reached at (919) 966-7456 or chris_jackson@unc.edu. Contact Dickinson at (919) 966-6236 or dmd@email.unc.edu.

UNC School of Public Health contact: Lisa Katz, (919) 966-7467 or lisa_katz@unc.edu
UNC News Services contact: Deb Saine, (919) 962-8415