5.25 Parent/family/home targeted interventions

Show / hide chapter menu

5.1 Introduction

5.2 Stages in the uptake of smoking

5.3 Factors influencing uptake by young people—overview

5.4 Physiological aspects

5.5 Individual personality traits and psychiatric influences

5.6 Intentions, attitudes and beliefs

5.7 The home environment

5.8 The smoking behaviour of peers, and peer attitudes and norms

5.9 The educational environment: achievements, aspirations and 'school connectedness'

5.10 Other drug use

5.11 Accessibility of tobacco products to young smokers

5.12 Affordability of tobacco products

5.13 Opportunity to smoke

5.14 Cultural background

5.15 Tobacco advertising and promotion targeted at young people

5.16 Products and packaging created to appeal to new users

5.17 Factors influencing uptake of smoking later in life

5.18 Uptake—a concluding note

5.19 What is meant by prevention?

5.20 Approaches to youth smoking prevention

5.21 Mass media strategies/campaigns

5.22 Interactive technology and multimedia

5.23 School-based interventions

5.24 Peer influence and education

5.25 Parent/family/home targeted interventions

5.26 Reducing tobacco access and supply

5.27 Reducing product appeal

5.28 Promotion and visibility of tobacco

5.29 Denormalising smoking

5.30 Taxation and pricing of tobacco products

5.31 Harnessing predictors of uptake to prevent smoking

5.32 Preventing smoking in more 'at risk' groups

Acknowledgments

References

Since parental behaviour emerges as a significant determinant of adolescent smoking in a number of studies,73, 95, 307 interventions that focus on the home environment are warranted and important. In addition to the powerful influence of a parent's own smoking behaviour,73, 76, 95 parental advice not to smoke or explicit disapproval of smoking can be effective in preventing young teens from smoking.307 Australian research concurs that young people cite parent disapproval of smoking as a barrier to uptake, although parents in the same study often felt that their opinions had little influence.98 Restrictions on smoking and parenting style (by combining demanding and responsive management of children's behaviour) can reduce smoking uptake, while permissive home policies increase the likelihood of experimentation77, 308 (see Sections 5.7.1 and 5.7.1.1 above).

Programs to intervene against smoking at the home level have shown mixed effect, with evaluation of program effectiveness hindered by insufficient information reported or lack of rigor in program implementation.307 One recent home-based program was shown to be effective in reducing the initiation of smoking by using a simple anti-smoking socialisation program among children whose parents smoke.309 Spoth310 found some evidence of a sustained effect, with lifetime cigarette use significantly lower among those participating in the Iowa Strengthening Families Program Group six years after intervention. Likewise, Storr311 observed that children had reduced smoking uptake in a family-school partnership intervention group when compared to the control group at seven year follow up. In a Cochrane Review of family-based programs for preventing youth smoking, four of nine trials testing a family intervention against a control group had significant positive effects, but one showed significant negative effects.307 One promising conclusion from the review was that across all of the included studies, the number of sessions was not related to positive outcomes, suggesting that program intensity is not a prerequisite for effectiveness. However, the extent of implementer training and the fidelity of implementation appeared to be higher in those studies with positive outcomes.307

5.25.1 Home-based smoking interventions in Australia

In Australia, the National Tobacco Strategy 2004–2009 (NTS)138 identifies supporting parents and schools with smoking prevention and cessation as a priority for intervention. One of the challenges articulated by the NTS is the need for 'more useful support for parents and educators' (p. 43). With each state reporting back annually on its progress against the NTS, it is evident that approaches to this challenge vary considerably. Queensland, for example, reported in 2006312 support for the Positive Parenting Program (Triple P), considered one of the first steps in reducing risk factors for smoking and drug use. However, while a variety of school-based programs (listed earlier) have been developed by each state, few programs (other than websites) specifically target parents and/or home environments in assisting with prevention of smoking among children.