Formative development of an intervention to stop family tobacco use: the Parents and Children Talking (PACT) intervention

The longitudinal, bidirectional relationships between parent reports of child secondhand smoke exposure and child smoking trajectories

This study examines the longitudinal relationships between child smoking and secondhand smoke exposure (SHSe). Participants were 222 parent-child dyads. The parents smoked, had a child with (48%) or without asthma, and were enrolled in a smoking/health intervention. Parent-reported child SHSe was measured at baseline and 4, 6, and 12-month follow-ups; self-reported child smoking was assessed at these points and at 2-months. A parallel process growth model was used. Baseline child SHSe and smoking were correlated (r = 0.30). Changes in child SHSe and child smoking moved in tandem as evidenced by a correlation between the linear slopes of child smoking and SHSe (r = 0.32), and a correlation between the linear slope of child smoking and the quadratic slope of child SHSe (r = - 0.44). Results may inform interventions with the potential to reduce child SHSe and smoking among children at increased risk due to their exposure to parental smoking.

Smokers who have children with asthma: Perceptions about child secondhand smoke exposure and tobacco use initiation and parental willingness to participate in child-focused tobacco interventions

OBJECTIVE

This study examined, among parents who smoke and have children with asthma, perceptions about child secondhand smoke exposure (SHSe), child tobacco use (TU) initiation, and parent willingness to participate in child-focused tobacco interventions.

METHODS

Participants were 300 caregivers who smoked and had a child with asthma (aged 10-14). Parents completed an online survey and self-reported perceptions about child SHSe elimination, child TU prevention, and willingness to participate in three types of interventions with and without their child (SHSe reduction intervention, tobacco prevention intervention, and the combination of the two). Correlates of perceptions and willingness were examined.

RESULTS

Parents who were ready to quit smoking and who reported home smoking bans (HSBs) were more motivated to eliminate SHSe (p < 0.05). Being white, younger, ready to quit, and having HSBs were associated with greater confidence to eliminate SHSe (p < 0.05). Parents with HSBs reported higher perceived importance about preventing child TU (p < 0.05). Parents were less confident about preventing male children from using tobacco (p = 0.001). Parents were highly willing to participate in all the described intervention approaches, with or without their child.

CONCLUSIONS

Parents were willing to participate in child-focused tobacco interventions, with or without their child with asthma, including interventions that address both child SHSe and TU prevention. This research demonstrates the acceptability of child-focused tobacco interventions among a high-risk population and may be a foundational step for intervention development.

Parent voices guide smoking intervention development

Purpose

– While parents’ influence on their children’s smoking behaviour is widely recognised, little is known about parents of four to eight year olds’ attitudes and beliefs around smoking cessation and how they communicate with their children about smoking. The purpose of this paper is to explore parents’ perceptions of quitting smoking and their beliefs and actions related to the use of parenting practices to discourage smoking by their children.

Design/methodology/approach

– Four focus groups and 17 interviews were conducted with parents (n=46) of four to eight year old children in Perth, Western Australia.

Findings

– Many parents indicated their children strongly influenced their quitting behaviours, however, some resented being made to feel guilty about their smoking because of their children. Parents were divided in their beliefs about the amount of influence they had on their children’s future smoking. Feelings of hypocrisy appear to influence the extent to which parents who smoked talked with their child about smoking. Parents recommended a variety of resource options to support quitting and talking with their child about smoking.

Practical implications

– Interventions aimed at parents who smoke and have young children should: reinforce parents’ importance as role models; highlight the importance of talking to children about smoking when they are young and provide strategies for maintaining ongoing communication; be supportive and avoid making parents feel guilty; and emphasise that quitting smoking is the best option for their child’s health (and their own), while also providing effective harm minimisation options for parents who have not yet quit.

Originality/value

– Parents of children of lower primary school age can be highly influential on their children’s later smoking behaviours, thus, effective interventions that address the current beliefs and practices of these parents may be particularly advantageous.

Smoke, smoking and cessation: the views of children with respiratory illness

OBJECTIVE

To explore the attitudes of Māori (indigenous New Zealanders) and Pacific children with respiratory illness towards smoking, secondhand smoke (SHS) and smoking cessation.

METHODS

Forty-one Māori and Pacific children (aged 6-11 years) in New Zealand (NZ) were interviewed about their attitudes towards smoking, how SHS affects them and their respiratory disease, ideas they have about how to reduce SHS exposure, their fears and concerns about smoking, and experience asking parents to quit smoking. The interviews were transcribed and deductively analysed.

RESULTS

The children said that SHS made them feel "bad," "angry," "uncomfortable" and "really sick," making them want to get away from the smoke. They were aware that smoking "is dangerous" and that "you could die from it." Many children had fears for smokers around them. The children reported on rules restricting smoking around children: "You're not allowed smoke in the car where babies are." A number of children reported that adults complied with those rules, but some reported that people still smoked around them. The children had experienced people around them quitting and had an awareness of how difficult it is to quit smoking. The most common reason perceived for quitting was concern for children. A lot of the children thought they could ask parents to quit and other suggestions included hiding people's tobacco, and use of smoke-free pamphlets, or signs.

CONCLUSIONS

Even young children from low socioeconomic minority groups are aware of the dangers of smoking and SHS, and hold negative views about smoking. Health promotion messages for parents could have more weight if they convey the concerns voiced by children.

Parent-focused change to prevent obesity in preschoolers: results from the KAN-DO study

OBJECTIVE

The study presents the immediate post-intervention results of Kids and Adults Now - Defeat Obesity!, a randomized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler (2-5 years old) dyads in North Carolina (2007-2011). The outcomes include change from baseline in the child's diet, physical activity and weight, and in the mother's parenting behaviors, diet, physical activity, and weight.

METHOD

The intervention targeted parenting through maternal emotion regulation, home environment, feeding practices, and modeling of healthy behaviors. 400 mother-child dyads were randomized.

RESULTS

Mothers in the intervention arm, compared to the control arm, reduced instrumental feeding (-0.24 vs. 0.01, p<0.001) and TV snacks (-.069 vs. -0.24, p=0.001). There were also improvements in emotional feeding (p=0.03), mother's sugary beverage (p=0.03) and fruit/vegetable (p=0.04) intake, and dinners eaten in front of TV (p=0.01); these differences were not significant after adjustment for multiple comparisons.

CONCLUSION

KAN-DO, designed to maximize the capacity of mothers as agents of change, improved several channels of maternal influence. There were no group differences in the primary outcomes, but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers' diets. Long-term follow-up will address whether these short-term trends ultimately improve weight status.

Dealing with a Latent Danger: Parents Communicating with Their Children about Smoking

The purpose of this study was to understand parental approach to the topic of smoking with school-age preadolescent children. In-depth interviews were conducted with 38 parents and yielded a grounded theory that explains how parents communicated with their children about smoking. Parents perceived smoking to be a latent danger for their children. To deter smoking from occurring they verbally interacted with their children on the topic and took action by having a no-smoking rule. There were three interaction approaches, which differed by style and method of interaction. Most parents interacted by discussing smoking with their children. They intentionally took advantage of opportunities. Some interacted by telling their children about the health effects of smoking and their opposition to it. They responded on the spur-of-the-moment if their attention was drawn to the issue by external cues. A few interacted by acknowledging to their children the negative effects of smoking. They responded only when their children brought it up. The parents' intent for the no-smoking rule, which pertained mainly to their homes and vehicles, was to protect their children from second-hand smoke and limit exposure to smoking. The theory can be used by nurses to guide interventions with parents about youth smoking prevention.

Interpersonal communication as an indirect pathway for the effect of antismoking media content on smoking cessation

In the context of health campaigns, interpersonal communication can serve at least 2 functions: (a) to stimulate change through social interaction and (b) in a secondary diffusion process, to further disseminate message content. In a 3-wave prospective study of 1,079 smokers, the authors demonstrate that mass media messages (antismoking campaigns and news coverage relevant to smoking cessation) have an indirect effect on smoking cessation intention and behavior via interpersonal communication. Exposure to campaigns and news coverage prompts discussion about the campaigns, and, in turn, about smoking cessation. Interpersonal communication regarding smoking cessation then influences intention to quit smoking and attempts to quit smoking. The study finds evidence not only for the social interaction function of interpersonal communication, but also for the secondary diffusion function. A substantial number of smokers who are not directly exposed to the antismoking campaigns are nevertheless indirectly exposed via communication with people who have seen these campaigns. These results imply that encouragement of interpersonal communication can be an important campaign objective.