Mothers' attitudes and concerns about their children smoking: do they influence kids?

Predictors of healthy behaviours in Swedish school children

AIM

To evaluate the impact of predictors of adopting a healthy lifestyle in Swedish schoolchildren.

METHODS

A sample of 1409 Swedish schoolchildren (mean age 12.5 years) representative of different socio-economic and geographical living areas participated in a questionnaire-based survey on healthy habits and knowledge of healthy behaviour. A logistic regression analysis was performed to identify intrapersonal, social and environmental predictors of healthy habits.

RESULTS

A normal body mass index (intrapersonal determinant) was connected to refraining from tobacco (P<0.05). For children to perceive family (P<0.001), themselves (P<0.001), or someone else (P<0.01) as a source of inspiration (social determinant) to be physically active was related to a high physical activity level. Paternal (P=0.01) and maternal (P<0.001) attention to the use of tobacco (social determinant) was of importance for children to refrain from such habits. To live in a socio-economically wealthy area (environmental determinant) was of importance for healthy food choices (P<0.01) and physical activity (P<0.05). Children from rural (P<0.01) areas (environmental determinant) were more physically active than children from urban areas.

CONCLUSION

Social aspects such as parental support for physical activity and refraining from tobacco were found to be important for healthy behaviours. Moreover, environmental factors such as socio-economic and geographical living area favourably influenced food choices and physical activity. Parental attitudes and economy are therefore important for physical activity, healthy food choices and refraining from tobacco in children. Consequently, future interventions need to address the psychological and environmental influences of the home environment through the active involvement of parents, even in school-based interventions.

Preteen Attitudes about Smoking and Parental Factors Associated with Favorable Attitudes

Purpose.

To describe youth smoking-related attitudes and evaluate the effects of parental factors on child adoption of positive attitudes about smoking.

Design.

This study used baseline and 20-month data from a family-based smoking-prevention study (82.9% completed both surveys).

Setting.

Telephone recruitment from two health maintenance organizations.

Subjects.

Children aged 10 to 12 years and one parent of each child (n = 418 families) were randomly assigned to a frequent assessment cohort (12.5% of participants).

Intervention.

Families received a mailed smoking-prevention packet (parent handbook, videotape about youth smoking, comic book, pen, and stickers), outreach telephone counselor calls to the parent, a newsletter, and medical record prompts for providers to deliver smoking-prevention messages to parents and children.

Measures.

Demographics, tobacco status, attitudes about smoking (Teenage Attitudes and Practices Survey), family discussions about tobacco, family cohesiveness (family support and togetherness), parent involvement, parent monitoring, and parenting confidence.

Results.

One-third of the children endorsed beliefs that they could smoke without becoming addicted, and 8% to 10% endorsed beliefs on the benefits of smoking. Children's positive attitudes about smoking were associated with lower family cohesiveness (p = .01). Parental use of tobacco was the only significant predictor of children's positive attitudes about tobacco at 20 months (p = .03).

Conclusions.

Children as young as 10 years underestimate addictive properties of smoking, which may place them at risk for future smoking. Parental use of tobacco and family cohesiveness are important factors in the formulation of preteen attitudes about smoking.

Secondhand smoke exposure among never-smoking youth in 168 countries

PURPOSE

To estimate the prevalence of secondhand smoke (SHS) exposure among never-smoking adolescents and identify key factors associated with such exposure.

METHODS

Data were obtained from nationally representative Global Youth Tobacco Surveys conducted in 168 countries during 1999-2008. SHS exposure was ascertained in relation to the location-exposure inside home, outside home, and both inside and outside home, respectively. Independent variables included parental and/or peer smoking, knowledge about smoke harm, attitudes toward smoking ban, age, sex, and World Health Organization region. Simple and multiple logistic regression analyses were conducted.

RESULTS

Of 356,414 never-smoking adolescents included in the study, 30.4%, 44.2%, and 23.2% were exposed to SHS inside home, outside home, and both, respectively. Parental smoking, peer smoking, knowledge about smoke harm, and positive attitudes toward smoke ban were significantly associated with increased odds of SHS exposure. Approximately 14% of adolescents had both smoking parents and peers. Compared with never-smoking adolescents who did not have both smoking parents and peers, those who had both smoking parents and peers had 19 (adjusted odds ratio [aOR], 19.0; 95% confidence interval [CI], 16.86-21.41), eight (aOR, 7.71; 95% CI, 7.05-8.43), and 23 times (aOR, 23.16; 95% CI, 20.74-25.87) higher odds of exposure to SHS inside, outside, and both inside and outcome home, respectively.

CONCLUSIONS

Approximately one third and two fifths of never-smoking adolescents were exposed to SHS inside or outside home, and smoking parents and/or peers are the key factors. Study findings highlight the need to develop and implement comprehensive smoke-free policies consistent with the World Health Organization Framework Convention on Tobacco Control.

A comparison of daily and occasional smokers' implicit affective responses to smoking cues

Previous research has not compared implicit affective responses to smoking-related stimuli in occasional (i.e., those who smoke less than one cigarette per day) and daily smokers (i.e., those who smoke at least once per day). In addition to assessing their motivations for smoking, implicit affective responses were measured using the Affect Misattribution Procedure (AMP) in occasional (n=19) and daily smokers (n=34) to smoking-related and neutral cues. Half of the cues depicted a human interacting with an object (i.e., active), whereas the remaining cues depicted objects alone (i.e., inactive). Results indicated that for the active cues, daily smokers responded more positively to smoking-related than to neutral cues, whereas occasional smokers showed no difference in their implicit responses. In addition to smoking frequency, relative differences in implicit responses to active cues were related to cognitive enhancement motivation. For inactive cues, implicit responses were related to cognitive enhancement as well as reinforcement. Because daily smokers have more positive implicit responses to active smoking-related cues than occasional smokers, these cues may play an important role in maintaining smoking behavior in daily smokers.

Peering through the smoke: the effect of parental smoking behavior and addiction on daily smokers' attentional bias to smoking cues

Although previous research has demonstrated that individuals with parents who smoke are more likely to become smokers and are less successful in smoking cessation efforts compared with those without a smoking parent, the reasons for this link have not been established. In the current study, implicit attentional bias to smoking-related cues was investigated in college-age smokers, based on models of addiction that suggest that attention to drug-related cues plays an important role in drug addiction. Sixty-one participants completed a dot-probe task to measure attentional bias to smoking-related and matched non-smoking-related control pictures. Results indicated that while those who reported smoking occasionally did not demonstrate an attentional bias, daily smokers who had a smoking parent showed more of an attentional bias to the smoking cues than those without a smoking parent, but only to cues that did not contain human content. In addition to parental influence, nicotine dependence explained a significant portion of the variance in the attentional bias for daily smokers. Implications for models of nicotine addiction and the development of smoking cessation programs are discussed.

Prevalence of youth cigarette smoking and selected social factors in 25 European countries: findings from the Global Youth Tobacco Survey

OBJECTIVES

To present Global Youth Tobacco Survey (GYTS) data on the prevalence of cigarette smoking and selected social factors among students aged 13-15 years in 25 European countries.

METHODS

The GYTS is a school-based survey of students aged 13-15 years. The GYTS was conducted in 25 European countries (2002-2005) and produced representative data for each country.

RESULTS

In 25 European countries studied, 22% of boys and 18% of girls smoked cigarettes. In 17 of 25 countries, current cigarette smoking did not differ between boys and girls. Exposure to secondhand smoke is very high throughout the 25 countries. Exposure to pro-tobacco indirect advertising (having tobacco company logos on promotional items and being given free cigarettes) is frequent throughout the countries.

CONCLUSIONS

Intensified efforts to lessen harm caused by tobacco use among youth in 25 European countries included in this study are urgently needed. These countries need to develop and implement comprehensive tobacco control programs including public education campaigns, cessation programs, enforcement of existing measures, and related policy efforts. The WHO FCTC provides a useful framework for implementing such a comprehensive approach.

Agreement between parents and youth on measures of anti-smoking socialization

BACKGROUND AND OBJECTIVES: Despite the current literature on the importance of parental anti-smoking socialization messages, it is unclear if youth and parents agree on the content and frequency of such messages. This study's purpose was to explore the level of agreement between parents and youth on measures of anti-smoking socialization and to assess whether agreement is associated with parental smoking status and/or parental race/ethnicity. METHODS: Data were collected from parent and 9-16 year old youth dyads who presented to the emergency department with a non-urgent complaint. A self-administered questionnaire assessing demographics and five antismoking socialization measures was used. RESULTS: Items that showed statistically significant agreement between parents and youth were frequency of explicit messages about smoking. However, the absolute agreement between the items was poor at less than 50% for the complete sample. Items that did not show statistically significant agreement between parents and youth were: maternal negative reaction to smoking (for all youth); specific rules about smoking and maternal negative reaction to smoking (for youth with parental smokers); and paternal negative reaction to smoking (for youth with parental nonsmokers). When pairs that did not agree were analyzed, there were significant discrepancies in youth-parent agreement by parental smoking status, but not by race/ethnicity. CONCLUSIONS: In this study, there was poor agreement between parents and youth on measures of anti-smoking socialization. Level of agreement was associated with parental smoking status, but not race/ethnicity. Since anti-smoking socialization is an important means to decrease youth tobacco initiation and use, future studies are needed to investigate the specific content, frequency, and format of parental anti-smoking messages that are best received and recalled by youth.

Racial/ethnic differences in parental concern about their child's drug use in a nationally representative sample in the United States

INTRODUCTION

Parental concern and negative attitudes toward drug use may prevent youth from being involved in drug use. However, few studies have addressed parental concern about children's drug use and its possible variation by race/ethnicity. In this study, we explored the potential racial/ethnic differences in parental concern about their children's drug use with a nationally representative sample.

METHODS

The data were from the 2003 National Survey of Children's Health, a random household telephone survey of parents of children up to age 17 (n = 102353). The analytic sample was restricted to parents of children aged 6 to 17 years (n = 61046). Multivariate logistic regression models, controlling for children's age, gender, family structure, and family poverty level, were fitted, simultaneously accommodating the complex survey design.

RESULTS

Parents of African American and Hispanic children expressed more concern than parents of white children, even after controlling for potential confounders (adjusted odds ratio (AOR), 1.9; 95% CI, 1.8-2.1 and AOR, 1.9; 95% Cl, 1.7-2.1, respectively).

CONCLUSIONS

The level of parental concern about adolescent drug use was different across race/ethnicity groups. The results may have implications for parental participation in school-based adolescent prevention programs.

Mechanisms of adolescent smoking cessation: roles of readiness to quit, nicotine dependence, and smoking of parents and peers

Multiple levels of influence should be considered in interventions aimed at the adolescent smoker, including psychological, addiction, peer and parental influences. However, the mechanism by which these variables influence the process of smoking cessation in adolescents is not well elucidated. Therefore, this prospective study tested two models among 850 adolescent smokers, specifying the direct and indirect relations between adolescents' readiness to quit smoking, levels of nicotine dependence, and smoking behavior of their parents and friends. One year later smoking cessation was assessed. Results showed that, among adolescent smokers, readiness to quit was positively associated with quit attempts, while nicotine dependence was inversely associated with successful cessation. Instead of a direct relation, parental and peers' smoking were inversely related to smoking cessation through nicotine dependence. The findings emphasize that interventions should be developed and tested within and outside the school setting, as well as within the family situation. In addition, the strong impact of nicotine dependence on successful cessation indicates that a more direct approach is needed to lower nicotine dependence among adolescents.

The 2005 British Columbia smoking cessation mass media campaign and short-term changes in smokers attitudes

The effect of the 2005 British Columbia (BC) smoking cessation mass media campaign on a panel (N = 1,341) of 20-30-year-old smokers' attitudes is evaluated. The 5-week campaign consisted of posters, television, and radio ads about the health benefits of cessation. Small impacts on the panel's attitudes toward the adverse impacts of smoking were found, with greater impacts found for those who had no plans to quit smoking at the initial interview. As smokers with no plans to quit increasingly recognized the adverse impacts of smoking, they also increasingly agreed that they use smoking as a coping mechanism. Smokers with plans to quit at the initial interview already were well aware of smoking's adverse impacts. Respondents recalling the campaign poster, which presented a healthy alternative to smoking, decreased their perception of smoking as a coping mechanism and devalued their attachment to smoking. Evidence was found that media ad recall mediates unobserved predictors of attitudes toward smoking.

Social influences, and attitudes and beliefs associated with smoking among border Latino youth

BACKGROUND

Adolescent smoking rates have declined among all ethnic groups since the late 1990s. However, despite the recent declines and intervention efforts, today smoking remains a serious problem among youth, with a quarter of adolescents being current smokers by the time they complete 12th grade. This problem is particularly prevalent among Latino youth, who have among the highest rates of lifetime and past-30-day use. The purpose of this study was to examine the association between psychosocial factors and the smoking behavior of Latino youth living along the Mexico-US border.

METHODS

A convenient sample of 2471 middle and high school Latino students was surveyed in fall 2000. Logistic regression analysis was used to examine the association between study risk factors and youth smoking behavior.

RESULTS

The strongest predictor of lifetime and past-30-day smoking was peer influence; however, the strength of the association was greater with recent use. There were also differences in the influence of family and attitudes and beliefs between the 2 groups.

CONCLUSIONS

These differences need to be taken into consideration to guide development of tailored prevention and control interventions aimed at this specific group. These efforts should address social influences to smoke, particularly those from peers; promote changes in attitudes and beliefs toward smoking; increase understanding of the addictive nature of nicotine; and provide development of skills young people need to resist social and environmental pressures to smoke. Strict control and enforcement measures are needed to completely eliminate the sale of cigarettes to minors.

The role of smoking-cessation-specific parenting in adolescent smoking-specific cognitions and readiness to quit

BACKGROUND

An instrument assessing smoking-cessation-specific parenting was developed and tested in relation to a) the pros of smoking and quitting and self-efficacy to resist smoking, and b) adolescent readiness to quit.

METHODS

Cross-sectional survey data from 998 Dutch adolescents who smoked regularly were used to perform structural equation analyses.

RESULTS

Adolescents who perceived relatively few advantages of smoking and many benefits of quitting reported a high readiness to quit. Self-efficacy was not related to readiness to quit. Smoking-cessation-specific parenting was both directly related to a high readiness to quit, and indirectly through the perceived pros of quitting. Also, if one or both parents were smokers, adolescents reported experiencing less smoking-cessation-specific parenting and a lower readiness to quit. However, in general, differences in paths were not found between adolescents with two parents who did not smoke and adolescents with one or two parents who smoked.

CONCLUSIONS

Given that anti-smoking socialisation has not yet been operationalised in terms of smoking-cessation-specific parenting, the present results will warrant further research into smoking-cessation-specific parenting in relation to adolescent smoking cessation. Further, parental smoking should not discourage parents from engaging in smoking-cessation-specific parenting as its relations with smoking cognitions and readiness to quit were highly similar in both the group with two parents who did not smoke and the group with one or two parents who smoked.

The joint influence of parental modeling and positive parental concern on cigarette smoking in middle and high school students

The purpose of the study was to examine the interaction between parental smoking status and parental attitudes, as measured by positive parental concern, on the risk of adolescent cigarette smoking. Parental smoking and parental concern about smoking were measured in a cross-sectional study of 37,244 students, a random sample of Maryland middle and high school students, who were current or never smokers. Parental concern was classified into 3 levels: strict, moderate, and minimal. The likelihood of youths being current smokers was positively associated with both parental smoking (both versus neither parent smokes: odds ratio [OR] 3.4, 95% confidence interval [CI] 3.1-3.7) and parental concern about smoking (minimal versus strict concern: OR 2.3, 95% CI 2.1-2.4). Youths with parents who did not smoke and with strict concern had the lowest likelihood of smoking. In comparison to this group, after adjustment for other social influences the likelihood of being a current smoker was more than 5 times greater among boys (OR 5.8, 95% CI 4.5-7.4) and girls (OR 5.2, 95% CI 4.1-6.5) whose parents both smoked and were minimally concerned about smoking. Current smoking in youths was independently associated with both parental smoking and less parental concern. When these 2 factors were jointly considered, the prevalence of current smoking in youths increased both with exposure to parental modeling and reduced parental concern about smoking. The results indicate that minimal parental concern about smoking worsens the risk due to parental modeling. Parental modeling and parental attitudes act synergistically to exacerbate the likelihood of smoking.

Nine-year prediction of adolescent smoking by number of smoking parents

For scientific and public health reasons, it is important to identify the role of family influences on child smoking acquisition. Using a well-followed (>90%) cohort of 3,012 children and their parents, this study prospectively investigated the influence of smoking by 0 vs. 1 vs. 2 parents when the children were young (3rd grade), on whether the children subsequently became daily smokers. It is the only study to investigate the prediction of child/adolescent smoking at the end of the smoking acquisition period (12th grade) by parental smoking at the start of the period (3rd grade). Logistic regression analyses revealed that having one parent who smokes substantially increases the risk that children will become daily smokers, relative to families where neither parent smokes (OR=1.90, p<.01). There is no evidence that the increased risk depends on parent or child gender. These results suggest the need for public health interventions that inform parents of young children that their own smoking behavior increases their children's risk for future smoking.

Children's hedonic judgments of cigarette smoke odor: effects of parental smoking and maternal mood

Age-appropriate tasks were used to assess 3- to 8-year-old children's liking, identification, and preference for a variety of odors, including that of exhaled cigarette smoke. Children whose parents smoke took longer to decide whether they liked the cigarette odor and were significantly more likely to prefer the odor of cigarette to the neutral and unfamiliar odor of green tea compared with children of nonsmokers. Among children of smokers, relative preferences for the cigarette odor were related to maternal mood disturbance and depression scores. These findings suggest that some early learning about cigarette smoke odor is based on sensory experiences at home and anchors it to the emotional context in which their mothers smoke.

Parental anti-smoking socialization. associations between parental anti-smoking socialization practices and early adolescent smoking initiation

This longitudinal study of 600 families concentrates on the influence of parental anti-smoking socialization by examining both (a) the effects of eight indicators of anti-smoking socialization on adolescent smoking and (b) the influence of parental smoking on the effectiveness of their anti-smoking socialization. Robust differences between smoking and non-smoking parents demonstrated that both kinds of families hold different norms and attitudes about adolescent smoking and how to deal with it. In terms of effective anti-smoking socialization, it appeared that parental involvement on a more abstract level, such as feeling confident one has influence on the smoking behaviour of one's child and having knowledge whether one's child and his or her friends smoke, seemed important in preventing early adolescent smoking, while concrete communication or house rules about smoking were not.

Parenting Style and Smoking-Specific Parenting Practices as Predictors of Adolescent Smoking Onset

OBJECTIVE

To test whether parenting style and smoking-specific parenting practices prospectively predicted adolescent smoking.

METHODS

Three hundred eighty-two adolescents (age 10-17 years, initial nonsmokers, 98% non-Hispanic whites) and their parents were interviewed, with smoking also assessed 1-2 years later.

RESULTS

Adolescents from disengaged families (low acceptance and low behavioral control) were most likely to initiate smoking. Adolescents' reports of parents' smoking-related discussion was related to lowered smoking risk for adolescents with nonsmoking parents, but unrelated to smoking onset for adolescents with smoking parents. Smoking-specific parenting practices did not account for the effects of general parenting styles.

CONCLUSIONS

Both parenting style and smoking-specific parenting practices have unique effects on adolescent smoking, although effects were largely confined to adolescents' reports; and for smoking-specific parenting practices, effects were confined to families with nonsmoking parents. Interventions that focus only on smoking-specific parenting practices may be insufficient to deter adolescent smoking.

Maternal/female caregiver influences on adolescent indoor tanning

PURPOSE

To identify aspects of maternal/female caregiver (MFC) influences on adolescents' indoor tanning, including modeling, cognitions (MFC knowledge and attitudes about indoor tanning), and gatekeeping/monitoring (MFC permissiveness and concern) of indoor tanning.

METHODS

A telephone survey of adolescents aged 14-17 years and their female parent/caregiver in Minnesota and Massachusetts was conducted in 2000-2001 (n = 1284 matched pairs). Logistic regression was used to obtain odds ratios for relationships between measures of MFC influence and teens' indoor tanning practices, adjusting for demographic and sun sensitivity differences.

RESULTS

Separately, each of the five MFC influence variables was significantly associated with adolescents' indoor tanning practices. In a multivariate model, significant independent contributors were parents' behavior, parents' concern about their children's indoor tanning practices, and MFC permissiveness of teen indoor tanning. Using a combined summed scale of the 5 influence factors, there was a monotonically increasing likelihood of tanning with each incremental scale increase: (in comparison to none, 1 factor aOR = 4.1, 95% CI: 1.3, 12.8; any 2 factors aOR = 8.3, 95% CI: 2.8, 24.6; any 3 factors aOR = 14.3, 95% CI = 4.9, 41.8; any 4 factors aOR = 30.5, 95% CI: 10.3, 90.3; all 5 factors aOR = 66.0, 95% CI: 20.0, 217.6).

CONCLUSIONS

Mothers/female caregivers may be a powerful influence on their teenagers' indoor tanning use, and are an important target for future health promotion efforts to discourage youth indoor tanning.

Lifetime parental smoking history and cessation and early adolescent smoking behavior

BACKGROUND

Associations are examined between parental smoking and smoking onset by their children. Smoking parents are more likely to have children who start smoking in their teenage years; however, less is known about whether parental quitting is related to adolescent smoking.

METHODS

A cross-sectional national sample of 2,206 adolescents, ages 10-14 years, living in two-parent households were interviewed for the DEFACTO annual report on Dutch youth smoking behavior. Adolescent smokers reported that they have tried smoking, even one puff. Respondents indicated whether their parents were never, former, or current smokers, and provided, in the case a parent had quit, their age at that time.

RESULTS

Logistic regression analyses revealed that likelihood increased gradually: adolescents with both parents being current smokers were four times more likely to be a smoker compared to adolescents with parents who had never smoked. Additionally, within the group of adolescents whose parents quit smoking, the findings demonstrated that the earlier the parents stopped smoking in the life of their offspring, the less likely their children were to start smoking in adolescence.

CONCLUSIONS

Parental smoking history is associated with smoking initiation in early adolescence. Parental cessation at an early age of their offspring reduces the likelihood of adolescent smoking initiation. Preventive efforts, therefore, should focus on the benefits of parental cessation as early as possible.

Racial/Ethnic Differences in Parent-Child Smoking Communication

A cross-sectional study of parents and children who presented to the ED at a Cincinnati hospital showed high parental smoking rates and lower rates of anti-smoking communication in African American parents, unlike prior studies.

Jóvenes y tabaco: prevalencia, patrón y actitud ante el consumo de tabaco

OBJECTIVES

To determine the prevalence of smoking among 12 to 14-year-olds in the province of Salamanca and to identify their knowledge of and attitudes to smoking as well as the impact of information provided on the subject in comic strip form.

MATERIAL AND METHOD

We performed a descriptive study (n = 4907). The variables analyzed were: age, sex, place of residence, school, smoking, and degree of awareness of the consequences of smoking before and after being given the comic book. Statistical analysis was carried out using measures of central tendency, the chi-squared test and Student's t-test T (p < 0.05).

RESULTS

Of the teenagers surveyed, 45.4 % of the boys and 39 % of the girls had smoked at some time and 20.5 % reported they were current smokers, with no differences between sexes. In both sexes the first cigarette was offered by a friend (59.8 % of boys and 66.5 % of girls). The teenagers began to smoke at a mean age of 11.1 years. Most of these adolescents smoked between 1 and 5 cigarettes a day. Most (91.8 %) considered tobacco to be a drug and after reading the comic strip this percentage rose to 99.1 %. A total of 70.1 % knew what passive smoking was, and after reading the comic strip this figure increased to 88.2 %. More than half (64.9 %) associated tobacco consumption with cancer, bronchitis and heart attack and 44.4 % considered mild cigarettes to be less harmful; after reading the comic strip these percentages changed to 95.3 % and 1.4 % respectively. Before reading the comic strip 84.2 % associated addiction with nicotine whereas after reading the comic this figure was 97.8 %.

CONCLUSIONS

Children have contact with tobacco at a relatively early age. Current information on smoking is acceptable but could be improved. Information provided through comic strips can be an effective way of reaching adolescents and of preventing them from taking up the habit.

High school students' attitudes about firearms policies

PURPOSE

To examine high school students' attitudes about firearm policies and to compare their attitudes with those of adults.

METHODS

The Hamilton Youth and Guns Poll is the first national survey of high school students about their attitudes concerning firearm policies. Questions were asked of 1005 sophomores, juniors, and seniors about their actual (i.e., direct) exposure (e.g., presence of a gun in the home) and about their social (i.e., indirect) exposure (e.g., whether the student could get a gun) to firearms and related violence. Population weights were applied, and multivariate logistic regression was used to examine the relationship between demographic and exposure variables and opinions about firearm policies.

RESULTS

Most high school students supported more restrictive firearm policies. Opinions varied little by demographic variables with the exception of gender. Females were significantly more supportive of most firearm policies. Actual exposure was a more consistent predictor than social exposure. Students living in a home with a gun, particularly a handgun, were less likely to support most restrictive gun policies.

CONCLUSIONS

Most high school students in the United States favor stringent policies governing firearms. Adolescents' attitudes about firearm policies parallel those of adults.

Family attention and tobacco smoking among adolescents in Central America, Panama, and the Dominican Republic

This study examined the association between family attention and tobacco use among 5549 adolescent students in five Central American countries, Panama, and the Dominican Republic who participated in a survey of drug use in 1994. Drug use and other variables were assessed using an adapted version of the Drug Use Screening Inventory (DUSI) in Spanish. Students with the highest level of family attention had a lower occurrence of tobacco smoking than students with the lowest level of family attention. Country-specific analyses show similar associations. These findings underscore the need to understand tobacco use in Central America and neighboring countries and to test whether interventions aimed at enhancing parental-child attention, communication, and monitoring reduce the incidence of tobacco use among youths.

Parental, family, and home characteristics associated with cigarette smoking among adolescents

PURPOSE

This study examines the relationship between smoking-related parental, family, and home factors with adolescents' cigarette use.

DESIGN

Cross-sectional surveys of adolescents, via a self-administered questionnaire in classrooms, and their parents, via a telephone interview, were conducted.

SETTING

Fifteen suburban and rural communities within Minnesota.

SUBJECTS

The study sample included 8th, 9th, and 10th grade public school students and their parents.

MEASURES

The dependent variable was monthly tobacco use among students. The independent measures were parental, family, and home smoking-related characteristics. There were 1343 parent-child dyads with completed surveys.

RESULTS

The final, multivariate logistic regression model found the following variables to be independently related to higher smoking rates among adolescents: child's grade (odds ratio [OR] = 3.03 for 10th vs. 8th), parents' permissiveness of adult smoking (OR = 1.80), parents' having higher normative estimates of how many people smoke (OR = 1.70), parents' decreased likelihood of punishing their teenager for smoking (OR = 1.65), smoking by an adult living in the home (OR = 1.99), and sibling smoking (OR = 8.95). Lack of communication about consequences for breaking family smoking rules was associated with lower smoking rates among adolescents (OR = .49).

CONCLUSION

The results of this study highlight the importance of parental smoking norms and attitudes and smoking role models in the home. It is important that smoking prevention strategies target and include the entire family. Limitations of the study are its cross-sectional design and that the sample was primarily white.

Smoking mothers and snuffing fathers: behavioural influences on youth tobacco use in a Swedish cohort

OBJECTIVE

To analyse the influences of parental use of cigarettes and snus (the Swedish variety of smokeless tobacco) on offspring's behaviour.

DESIGN

Prospective cohort study.

SETTING

The Stockholm County of Sweden.

SUBJECTS

2232 adolescents recruited in the fifth grade (mean age 11.6 years) with follow up in the eighth grade.

MAIN OUTCOME MEASURES

Self reported tobacco use (ever and current use of cigarettes and/or snus) in the eighth grade.

RESULTS

Parents' tobacco use was associated with adolescents' current use of cigarettes and snus (odds ratio (OR) 2.7, 95% confidence interval (CI) 1.8 to 3.9 if both parents used tobacco v neither parent). Mother's cigarette smoking was associated with adolescents' current exclusive smoking (OR 2.4, 95% CI 1.6 to 3.6). Father's use of snus was associated with current exclusive use of snus among boys (OR 3.0, 95% CI 1.4 to 6.4), but not with current cigarette use. The overall prevalence of current smoking was lower among children whose fathers used snus than among those whose fathers smoked.

CONCLUSIONS

Parental smoking, especially maternal smoking, enhances the risk of tobacco experimentation in youths, as does paternal use of smokeless tobacco. However, the transition to regular cigarette smoking is not likely to be affected by paternal use of smokeless tobacco. Contextual factors, in particular declining smoking trends and negative social acceptance of smoking, can explain most of these findings.

The association among adolescents' tobacco use, their beliefs and attitudes, and friends' and parents' opinions of smoking

OBJECTIVE

To examine adolescents' attitudes toward smoking, the presence of a false consensus effect, and the influence of peer and parental attitudes about smoking choices on being a susceptible, never smoker; an experimenter; and a current smoker.

METHODS

Data from The Robert Wood Johnson Foundation's 1996 National Study of Tobacco Price Sensitivity, Behavior, and Attitudes Among Teenagers and Young Adults (RWJF survey) were used to produce national estimates of the tobacco use behaviors and attitudes of adolescents enrolled in high school. Three logistic regression models were estimated to examine which psychosocial variables were associated with three different stages of smoking uptake.

RESULTS

Positive attitudes toward tobacco use were associated with a greater likelihood of being a susceptible, never smoker (OR = 1.50), an experimenter (OR = 1.27), and a current smoker (OR = 2.96). Those respondents who believed that 50% or more of all adolescents smoked were more likely to be current smokers (OR = 1.45). The importance of the opinions of one's friends and parents about his/her choice to smoke was also found to be associated with smoking behavior.

CONCLUSIONS

Preventing the initiation and continuation of smoking among adolescents will require interventions that address individual attitudes with respect to tobacco and will also need to present a clear picture of adolescent smoking. In addition, prevention and intervention messages should emphasize the importance of parental opinions on youth tobacco use regardless of parental tobacco use behavior.