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Q & A: Parenting as Prevention
Questions you may have about parenting as prevention
As the baby boomers hit parenthood head-on, an avalanche of advice surrounds
them about how to be parents—even from the tobacco industry itself. What’s a
parent to believe? What really works? How do you know what is credible?
This parenting kit provides a research-based approach to help parents
reconnect with their children if the bond has somewhat slipped. The materials
are geared specifically for parenting practices relevant to tobacco use,
although they have application for parents interested in nurturing a wide range
of healthy behaviors.
It is likely that, as you begin your parent outreach campaign, you will have
a few questions or be expected to answer others’ questions about a tobacco
control program aimed at parents. Hopefully, we have addressed most of these
questions below. However, if you have additional inquiries, please send them to
tobaccoinfo@cdc.gov.
Q: Does a parent or other family member’s attitude about tobacco
influence a teen’s likelihood to try tobacco products?
A: Research suggests that parental attitude is very important. If a
parent is indifferent or permissive toward the issue of tobacco use, a
teenager’s likelihood of smoking increases.1,2 The value a parent places on a
tobacco-free lifestyle—regardless of whether a parent uses tobacco—carries
significant weight. Nolte and colleagues found that parents’ attitudes may
exert more influence than parents’ behavior (1983).3 If a child
believes his
or her parents would be upset if he or she smoked, the child is less likely to
smoke, even if both parents smoke. According to a 1998 study by Fearnow and
colleagues, cigarette smoking prevention programs may be improved by the
following:
- Increasing parents’ values on their child not smoking; increasing
parents’ belief about the health risks of smoking.
- Helping parents cope with stress.
- Being particularly aware of the differential effect that these factors
(parental values and parental stress level) can have on mothers and
fathers and on parents who smoke cigarettes themselves or who have smoked
in the past.
Footnotes
1. Fearnow, M., Chassin, L., Presson, C., “Determinants of parental attempts
to deter their children’s cigarette smoking,” Journal of Applied
Developmental Psychology, 1998; 19(3):453–468.
2. Tyas, S., Pederson, L., “Psychosocial factors related to adolescent
smoking: a critical review of the literature,” Tobacco Control, 1998; 4:409–420.
3. Nolte, A.E., Smith, B.J., O’Rourke, T. “The relative importance of
parental attitudes and behavior upon youth smoking behavior,” Journal of
School Health, 1983;53(4):264–271.
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Q: What influence does a parent who uses a tobacco product have on the
likelihood that their teenager will take up the habit?
A: This question represents a longstanding debate in the science
community. The 1994 Surgeon General’s Report says findings are mixed on how
clear the connection is between parents who smoke and young people who smoke.
Since that time, researchers have made stronger cases that parental smoking is
strongly related to offspring smoking. Research also shows that when a sibling
uses tobacco, the chances are greater that other adolescents in the family will
try the product. Yet, a child will not necessarily use tobacco simply because a
family member does. Parents who are current or ex-smokers but who respect a
tobacco-free lifestyle can still have a positive influence on their children.
Fearnow and Chassin found in their study: “Even for smoking parents, those who
valued their child’s remaining a nonsmoker were more likely to take active
efforts to achieve this goal.”1,2 As mentioned earlier, Nolte and colleagues
found that parents’ attitudes may exert more influence than parents’
behavior. If a child believes his or her parents would be upset if he or she
smoked, the child is less likely to smoke, even if both parents smoke.3 Resnick
and his colleagues also found that parents smoking might be more of an access
issue than a role-model issue, where children whose parents smoke have greater
access to cigarettes and this contributes to a greater likelihood of smoking.
Cohen, Richardson, and LaBree found that parental use of tobacco was not as
influential in increasing tobacco use; instead, good communication, greater time
spent and more parental monitoring in sixth grade indirectly reduced a child’s
chance of smoking through eighth grade. Gender may play a role in a child’s
uptake of tobacco. Girls may show a stronger association with becoming smokers
if their mothers are smokers. Yet while these parental associations may exist,
this does not mean that parents are to blame—because of either their parenting
practices or their use of tobacco products—for a teen’s uptake of tobacco
products. All teens who smoke do not all have parents who smoke; all parents who
smoke do not all have children who smoke. Overall, a parent who smokes may
influence his or her child to smoke—or may influence the child not to smoke.
The decision to become a tobacco user appears to be the result of many internal
and external influences that exert power over a person’s decision to consume
tobacco products.4
Footnotes
1. Chassin, L., Presson, C., Todd, M., “Material socialization of adolescent
smoking: the intergenerational transmission of parenting and smoking,”
Developmental Psychology, 1998;34(6):1189–1201.
2. Scientific Foundations for Parenting Meeting, Aug. 18–19, 1998, Atlanta,
GA, unpublished report.
3. Fearnow, M., Chassin, L., Presson, C., “Determinants of parental attempts
to deter their children’s cigarette smoking,” Journal of Applied
Developmental Psychology, 1998; 19(3):453–468.
4. Nolte, A.E., Smith, B.J., & O’Rourke, T. “The relative importance of
parental attitudes and behavior upon youth smoking behavior,” Journal of
School Health, 1983; 53(4):264–271.
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Q: What is known about parenting style and a young person’s decision
to try using tobacco?
A: Child development scholars characterize parenting styles into four
categories: (1) authoritarian (strict, rule- and consequence-based); (2)
authoritative (somewhat flexible but having clear boundaries); (3) permissive
(less emphasis on rules and consequences); and (4) neglectful (little if any
attention to child’s behavior). “An authoritative, positive parenting style
has been associated with lower levels of adolescent smoking,”1 particularly in
Caucasian families. However, some preliminary research suggests that the
stricter, authoritarian (not authoritative) parenting style that often
characterizes ethnic minority families—particularly if in more dangerous
and/or inner city environments—is associated with lower smoking rates among
these populations.2 Questions about parenting styles and cultural differences
stirred a major debate during CDC’s scientific meeting on parenting held in
1998. In general, participants pointed out that parenting styles can be strongly
influenced by cultural traditions and that what works for one culture may not
necessarily be transferable to another.3 In short, there are many nuances
regarding style, culture, gender, personality, and other factors that influence
“successful” parenting. For example, research shows that various parenting
styles and characteristics may affect males and females differently. Low
parental concern has been shown to increase the risk of boys taking up regular
smoking. With girls, poor communication with parents and restrictions on going
out raises the prevalence of smoking for girls. Also, a permissive, distracted
family environment is shown to be associated with illicit drug use in girls.
Overall, research suggests that across cultures parental expectations play a
significant role. If youth perceive that parents don’t care whether they
smoke, they are more likely to take up the habit. If youth feel parents do
care—and that consequences may occur if they smoke—kids are more likely to
resist tobacco. This is especially the case in many ethnic minority families in
which respect of parental wishes plays a powerful role. One key message from
research suggests that parents should choose the parenting style they prefer,
and within that style, if they establish clear expectations about not using
tobacco, their stance can make a big difference in their kids choices about
tobacco use.2
Footnotes
1. Tyas, S., Pederson, L., “Psychosocial factors related to adolescent
smoking: a critical review of the literature,” Tobacco Control, 1998;
4:409–420.
2. Mermelstein, R.,“Culture, gender and adolescent smoking,” Robert Wood
Johnson Foundation Conference, New Partnerships and Paradigms for Tobacco
Prevention Research, Sundance, UT, May 6–9, 1997.
3. CDC’s Scientific Foundations for Parenting Meeting, Aug. 18–19, 1998,
Atlanta, GA, unpublished report.
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Q: What specific aspects of parenting are shown to be associated with
the likelihood of adolescent smoking?
A: Research suggests that
certain broader parenting practices can leave a teenager more susceptible to
tobacco use. Parental supervision, attachment, support, and parenting style are
factors associated with smoking status among adolescents. Here is an example
from one study: “Our data suggest that mothers who provide lower levels of
support and less consistent discipline have adolescents who are more likely to
smoke cigarettes.”1 This and other studies also suggest that “discipline was
effective only in the context of a supportive mother-child relationship.”1,2 As
the parenting kit attempts to portray, relationship and connectedness between
parents and their children appear to be strong protective factors against not
only tobacco use but other risky youth health behaviors.
3,4 Yet, despite these
findings, this does not mean that parents are to blame for a child’s decision to
use tobacco products. Family environment is only one of many influences on a
child’s development.5
Footnotes
1. Chassin, L., Presson, C., Todd, M., “Material socialization of adolescent
smoking: the intergenerational transmission of parenting and smoking,”
Developmental Psychology, 1998; 34(6):1189–1201.
2. Tyas, S., Pederson, L., “Psychosocial factors related to adolescent smoking:
a critical review of the literature,” Tobacco Control, 1998; 4:409–420.
3. Resnick, M.A., Bearman, P.S., Blum, R.W., Bauman, K.E., Harris, K.M., et al.
“Protecting adolescents from harm: findings from the national longitudinal study
on adolescent health,” Journal of the American Medical Association, 1997;278(10):823–832.
4. You can access more findings from the ADD-Health Study, as well as other
interesting and relevant publications on healthy adolescence at the Web site for
the Konopka Institute for Best Practices in Adolescent Health
(www.peds.umn.edu/peds-adol/Konopka/index.html). The institute was established
in January of 1998 as a special initiative of the schools of medicine‚ nursing
and public health in the Academic Health Center of the University of Minnesota.
5. This point was made clear at Scientific Foundations for Parenting Meeting,
Aug. 18–19, 1998, Atlanta, GA. Also, behavioral science offers a host of
theories and models that analyze how human behavior is influenced by internal
and external forces. A few examples commonly used in public health include
social learning theory, diffusion of innovation, stages of change, and theory of
reasoned action. A good source for more explanation of these and other theories
is Glantz, K., Lewis, F.M., Rimer, B.K., eds., Health behavior and health
education: Theory, Research, and Practice, San Francisco:Jossey-Bass, 1999.
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Q: Does this campaign imply that parents are to blame if their child
becomes addicted to tobacco?
A: No. In interviews with several state tobacco control advocates we
learned that any campaign aimed at parents should provide a guilt- and
stress-free approach, as parents are already overwhelmed with “how-to”
messages. In response to this request, we did extensive research with parents to
identify concepts and messages that are perceived as positive, relevant, and
easy to follow.
This campaign recognizes that parents are not to blame if their kids become
smokers, but that they are clearly one of the external factors that can
influence a child’s decision. Just as parents who smoke or use spit tobacco
can inadvertently pass along the habit to their children, parents also can be a
strong protective factor against tobacco use by kids. Rather than blaming
parents, the Got a Minute? campaign is designed to include parents as one of
many places youth can find support for learning how to resist the lure of
tobacco products.
Footnotes
1. Behavioral science offers a host of theories and models that analyze how
human behavior is influenced by internal and external forces. A few examples
commonly used in public health include social learning theory, diffusion of
innovation, stages of change, and theory of reasoned action. A good source for
more explanation of these and other theories is Glantz, K., Lewis, F.M., Rimer,
B.K., eds., Health behavior and health education: Theory, research, and
practice, San Francisco:Jossey-Bass, 1999. Another good source is
“Theory at a Glance: A Guide for Health Promotion Practice,” from the
National Institutes of Health. It is available at the NIH website at this
address:http://cancer.gov/cancerinformation/theory-at-a-glance
2. Flay, B., Petraitis, J., “The theory of triadic influence: a new theory of
health behavior with implications for preventive interventions,” Advances in
Medical Sociology, 1994; 4:19–44.
3. Clayton, R.R., “Psychological approaches to understanding the etiology of
tobacco use,” Robert Wood Johnson Foundation Conference, New Partnerships and
Paradigms for Tobacco Prevention Research, Sundance, UT, May 6–9, 1997.
4. Tyas, S., Pederson, L., “Psychosocial factors related to adolescent
smoking: a critical review of the literature,” Tobacco Control, 1998; 4:409–420.
5. Fearnow, M., Chassin, L., Presson, C., “Determinants of parental attempts
to deter their children’s cigarette smoking,” Journal of Applied
Developmental Psychology, 1998;19(3):453–468.
6. Jackson, C., Henriksen, L., Dickinson, D., Levine, D., “The early use of
alcohol and tobacco: Its relation to children’s competence and parents’
behavior,” American Journal of Public Health, 1997; 87(3):359–364.
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