Health Education Research, Vol. 19, No. 3, 227-238,
June 1, 2004
© 2004 Oxford University Press
Communication about smoking in Dutch families: associations between anti-smoking socialization and adolescent smoking-related cognitions
1 Institute of Family and Child Care Studies, University of Nijmegen, PO Box 9104, 6500 HE Nijmegen and 2 Stiuoro, Den Haag, The Netherlands 3 Correspondence to: R. C. M. E. Engels; e-mail: R.Engels{at}ped.kun.nl
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Abstract |
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Parents play an important role in the development of young people’s smoking behavior, through the modeling effects of their own smoking status, through the ways they raise their children and through the ways they deal with smoking at home. The present study focused on anti-smoking socialization by, first, comparing the perspectives of both parents and an adolescent on eight indicators of anti-smoking socialization. In addition, we aimed to examine how these indicators of anti-smoking socialization are related to adolescent smoking-related cognitions (e.g. attitudes, self-efficacy, intentions to smoke). Data were collected from 116 Dutch families with fathers, mothers and adolescents (10–19 years old) included. Self-reports of these family members were used by means of questionnaires that were sent through the Internet. The findings showed that parents and adolescents differ in their reports on anti-smoking socialization. In general, mothers are more positive about anti-smoking socialization than adolescents and fathers. Furthermore, the results demonstrate that aspects of anti-smoking socialization, such as parental monitoring, norms on adolescents smoking and reactions on adolescent smoking, are related to smoking-related cognitions, such as negative attitudes to smoking, lower intentions to start smoking and higher self-efficacy. These findings are a first step in research on smoking-specific socialization that is considered to be of importance for the development of effective smoking prevention programmes focusing on parents. Nonetheless, longitudinal studies on large samples of families are needed to replicate the findings in this study.
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Introduction |
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How do parents affect adolescent smoking behavior? An impressive number of empirical studies have focused on this question in the past decades (Conrad et al., 1992
; Petraitis and Flay, 1995). Various cross-sectional and longitudinal studies showed that when parents smoke and have liberal norms concerning youth smoking, it is more likely that their children will start to smoke [e.g. (Chassin et al., 1986, 1998; Goddard, 1990; Friestad, 1998; Engels et al., 1999)]. Furthermore, parents affect their offspring’s smoking behavior by the way they raise their children. Parental socializing practices are related to a wide range of problem behaviors in adolescence (Chassin et al., 1998). According to Baumrind (Baumrind, 1987), adolescents are less likely to engage in problem behaviors, such as alcohol, drugs, delinquency and smoking, if they (1) get emotional and behavioral support from their parents in their activities in- and outside the family, and (2) are moderately controlled by their parents in their activities. In families where parents are loving, stimulating and supportive, but also monitor their children’s activities and control their whereabouts, children are more likely to refrain from smoking. Longitudinal surveys by Simons-Morton et al. (Simons-Morton et al., 1999) and Cohen et al. (Cohen et al., 1994) have clearly demonstrated that parental monitoring prevents adolescents from experimenting with smoking. In addition, Chassin et al. (Chassin et al., 1998) found that low levels of parental support are a precursor of adolescent smoking. In sum, there is substantial empirical evidence that parents affect adolescent smoking behavior through their own smoking behavior and through their parenting practices. The importance of concentrating research on parental influences stems from the facts that (1) the large majority of people experiment with smoking in their teenage years and (2) once young people start smoking, it is very hard for them to quit (Skinner et al., 1985; Rose et al., 1995). Although there are a number of studies on specific parental influences, such as parental smoking and parenting practices, we still have little insight into how exactly parents deal with the issue of adolescent smoking at home [see (Jackson and Henriksen, 1997)].
There have only been a few empirical studies conducted on anti-smoking socialization or, in other words, how parents deal with their children’s smoking. Clark et al. (Clark et al., 1999) carried out a cross-sectional study in the US among 311 parents of children aged 6–17 years on house rules on smoking, the effect of these rules on adolescent smoking and on the presence of tobacco advertisements at home. Their findings showed that 87% of the parents reported they had some kind of house rules concerning smoking at home and 11% indicated that they had explicitly forbidden their offspring to smoke at home. In a study among 1213 adolescents, Jackson and Henriksen (Jackson and Henriksen, 1998) demonstrated that when parents have certain anti-smoking strategies, such as establishing non-smoking rules, warnings about smoking risks and punishing if they found out that their child smoked, these children are less likely to smoke. Although anti-smoking socialization appeared to be more effective for non-smoking parents than for smoking parents, their findings showed that even when parents smoke, they could successfully establish and enforce standards on smoking at home. Furthermore, parental monitoring appeared to be a strong factor. When adolescents think that their parents are unlikely to find out that they smoke, they are 4 times more likely to smoke than if adolescents think that their parents would find out immediately (Simons et al., 1999). If adolescents think that smoking will result in negative consequences from their parents, they are less likely to smoke. In addition, when parents regularly talk about smoking, their children are less likely to start smoking. Henriksen and Jackson (Henriksen and Jackson, 1998) argue that parents should have a restrictive policy on adolescent smoking. Although many parents believe that a restrictive policy perhaps may stimulate their children to stand up against their parents and do the opposite of what their parents want, they do not find evidence for this phenomenon. In contrast, other studies indeed have found some empirical evidence suggesting that punishments and strong negative reactions may have an aversive effect. Andrews et al. (Andrews et al., 1993) showed that strong negative reactions of parents to adolescent smoking resulted in higher levels of adolescent smoking. Nonetheless, they also found that children of parents who warn of the effects of smoking are more likely to refrain from smoking. In sum, there is preliminary evidence that parental anti-smoking socialization may be effective in prohibiting adolescent smoking. Current studies focus on the control and support dimensions that are prominently apparent in the parenting literature [see (Baumrind, 1987)]. For instance, having house rules on smoking and active supervision on offspring’s whereabouts can be seen as controlling parental actions, whereas talking with the child about smoking, and being constructive and positive when finding out that the child experiments with smoking can be seen as supportive parental actions. However, more research is needed to find out which specific parenting practices are effective methods for dealing with adolescent smoking.
Anti-smoking socialization and general parenting orientations are related (Darling and Steinberg, 1993). For instance, parents who stimulate and support their children in their activities and the problems they encounter in life are more likely to be constructively in the ways how they deal with adolescent smoking behaviors at home. A pilot study of Henriksen and Jackson (Henriksen and Jackson, 1998) suggests that authoritative parents more often endorse non-smoking rules, and give warnings on the dangers of smoking and punishments when they find out that their child starts to smoke.
Understanding anti-smoking socialization is important for the development of effective prevention programmes. Although most school-based prevention programmes employ methods to train youngsters to cope with peer pressure, provide them with information on the pros and cons of smoking, and teach them how to deal with the persuasive messages of tobacco advertising (Bruvold, 1993), there is an increasing interest in programmes that include parents as a major source of influence on adolescent smoking. In the US, some institutes have recently developed programmes, in most cases integrated in regular programmes for secondary school students, that focus on both parents and adolescents [e.g. (Young et al., 1996)]. Preliminary reports on these programmes show promising results [see (Perry et al., 1993)]. However, in order to know precisely which factors within the nuclear family effect young people’s smoking, it is relevant to focus attention on communication about smoking in families and on smoking-specific parenting practices.
The current study
This study is one of the first to concentrate on the associations between anti-smoking socialization and adolescents’ smoking cognitions through gathering data from fathers, mothers and adolescents. Self-report questionnaires have been administered to 116 families consisting of both parents and one adolescent. This study enables us (1) to compare paternal and maternal influences, and (2) to compare adolescents’ perceptions of anti-smoking socialization with those of their parents.
Eight indicators of anti-smoking socialization were employed, i.e. communication about smoking, parental warnings, parental monitoring, availability of cigarettes at home, expression of parental norms, perception of parental influences, house rules and reactions towards adolescent smoking. In the current study, we examined (1) the prevalence of these indicators of anti-smoking socialization, (2) differences between family members, and (3) the associations between anti-smoking socialization and smoking-related cognitions of adolescents.
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Method |
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Procedure and sample characteristics
The study consisted of a sample of 116 two-parent families consisting of both parents and one adolescent aged 10–19 years old. The research institute Veldkamp carried out the data collection in the summer of 2000. The sample was drawn from an existing national representative panel of 16 000 households. Each member of this panel had a personal computer at home and the questionnaires had been sent to respondents by E-mail. As people in low socioeconomic conditions are less likely to have a personal computer, the research institute provided the families with personal computers for the period in which they were part of the panel. Families had been selected on the basis of the following criterion: an adolescent aged 10–19 living at home with both parents. In addition, families were chosen to obtain sufficient variation on smoking behavior of parents, and adolescents’ age, gender and educational level. Initially, 450 respondents were recruited, of which 315 returned a self-report questionnaire by E-mail (70% response rate).
The questionnaires were strictly confidential. They were sent through the specific E-mail addresses of the adolescent and his or her parents. We made special checks to ensure that participants filled out their own form and not the one of other family members. Still, despite all the efforts we made, we acknowledge the fact that it might be possible in some cases that (1) other family members filled out the form and (2) other family members were present when the adolescent filled out the form. However, it is important to stress that this is also a problem in studies that send questionnaires to homes and leave participants to fill out the forms by themselves. What happens at home is thus uncontrollable. The same goes for telephone surveys—it is possible that other family members are in the room when a respondent (e.g. adolescent) has to answer questions on his/her relationship with other family members or on problem behaviors. Still, we would like to stress that research is needed to compare the quality of data collected with this relatively new method (i.e. the Internet) to other methods such as telephone interview and personal interviews.
In addition, we used incentives to encourage people to participate in our study. For instance, respondents did not only get paid when they returned the forms (US$7), but when all three members of the family returned the forms, an extra amount of money (US$7) was received by the family as a whole.
In total, 209 parents and 106 adolescents participated in our study. In the majority of cases (86%) we had complete data on all family members. The mean age of the adolescents was 14.6 (SD = 2.94), and ranged between 10 and 19. Fifty-one percent of the adolescents were males. Concerning educational levels of the adolescents, 26% were lower educated (special and low education), 44% middle educated (trade school education) and 27% higher educated (preparatory college and university education). With respect to parental smoking, 33% of the families had non-smoking parents, 33% had one smoking parent and 33% had two smoking parents.
Measures
The questionnaire consisted of items assessing adolescents’ intentions to smoke, attitudes, self-efficacy to resist smoking and vulnerability to peer pressure. These determinants of adolescent smoking initiation [e.g. (De Vries et al., 1996; Engels et al., 1999)] were only competed by the adolescents. All family members completed the scales on indicators of anti-smoking socialization.
We focused on the role of anti-smoking socialization on adolescents smoking cognitions and not on actual smoking behavior. The most important reason for this choice is that because of the broad age range of the adolescents in our sample, only a limited number of respondents (n = 19) are smoking on a regular basis, thus creating a problem with statistical power. Therefore, it is better to focus on predicting smoking intentions to start smoking in this group of respondents. It is important to state that many studies show the predictive power of smoking intentions on smoking onset in non-smoking adolescent samples [see review by (Engels et al., 1999)].
Intention to smoke
De Vries’ (De Vries, 1988) scale was employed to measure young people’s motivations to smoke in the near future. Five items were: ‘Do you intend to smoke (or continue to smoke) ever/with friends/with parents/within 6 months/within 2 years’. Response categories ranged from 1 ‘definitely not’ to 5 ‘definitely yes’. The internal consistency was high, with Cronbach’s 
= 0.93. The scores were summed so that a high score implies a high intention to smoke.
Attitudes
The Smoking Attitude Scale developed by De Vries [(De Vries, 1986); see also (Engels et al., 1998, 1999)] was used, consisting of 22 items. Examples are: ‘If I smoke, this would be bad for my health’ and ‘If I smoke, it will reduce feelings of stress’. Respondents were asked to answer on a five-point scale from 1 ‘definitely not’ to 5 ‘definitely yes’. The internal consistency was high, = 0.90. Higher scores imply a stronger pro-smoking attitude.
Self-efficacy
Six items were abstracted from a nine-item self-efficacy scale (De Vries et al., 1988; Engels et al., 1998, 1999), and measured adolescents’ confidence in their ability to become (or stay) non-smokers and their confidence that they could refuse a cigarette when offered. An example question was: ‘To become (or to stay) a non-smoker is...very difficult for me’ (1) or ‘...very easy for me’ (7). Cronbach’s was 0.92. Higher scores imply a stronger confidence not to smoke.
Vulnerability to peer pressure
Previous research showed that it is extremely difficult to assess the adolescent’s vulnerability to peer pressure in surveys. One cannot simply ask adolescents to say how much pressure they perceive from their friends or peers because they are often very reluctant to admit that they are, indeed, subject to actual peer pressure (Engels et al., 1997). In order to address these problems, we developed a new measurement using scenarios. Respondents were presented with a story in which a boy went out with his friends on an ordinary Saturday night. Late in the evening, the boy was asked by a friend whether he would like to try a cigarette. This friend was a popular boy and had a high status in the peer group. Although the boy was a non-smoker, he was in doubt about accepting the cigarette. Furthermore, his friend tried to find support among the other peer group members to persuade the boy to take the cigarette. After this story, respondents were asked to imagine they were the boy in the story. Then, we asked what they would do in this particular situation—accept the cigarette or refuse it? Also, we asked them whether they would stick to one cigarette or would light up another one. The correlation between these two questions was high, r = 62, P < 0.001. Response categories ranged from 1 ‘very unlikely’ to 7 ‘very likely’. High scores imply that respondents are highly vulnerable to peer pressure.
Anti-smoking socialization
Eight measures of anti-smoking socialization were devised: communication about smoking, parental warnings, monitoring, availability of cigarettes at home, parental norms, parental influence, house rules and perception of parental reactions.
Communication about smoking was designed to assess the frequency that parents start discussions about smoking at home. The scale consisted of five items. Examples of items are: ‘How often do your parents talk about smoking’ and ‘How often do your parents discuss at what age you may start to smoke’. Notice that the phrasing of the questions is slightly different for the parent version. Response categories ranged from 1 ‘never’ to 5 ‘at least once a week’. Cronbach’s s were 0.79 (adolescents), 0.80 (mothers) and 0.78 (fathers).
Parental warnings aimed at measuring how often parents make explicit warnings about the dangers and disadvantages of adolescent smoking. The scale consisted of seven statements. Adolescents had to indicate how often their parents made these statements. Parents also had to report how often they themselves made these statements. Sample items are: ‘It is very hard to quit once you started smoking’ and ‘Smoking does not make you popular among friends’. Responses ranged from 1 ‘never’ to 5 ‘very often’. Internal consistencies were 0.88 (adolescents), 0.85 (mothers) and 0.80 (fathers).
Monitoring assessed whether parents know if their child smokes or intends to smoke, and if their friends smoke or intends to smoke. Sample items are: ‘Do you think your parents/you will find out easy if you/your child starts smoking?’ and ‘Do your parents/you know if the friends you hang out with, smoke?’. Response categories ranged from 1 ‘absolutely not’ to 5 ‘absolutely yes’. Internal consistencies were 0.63 (adolescent), 0.60 (mother) and 0.62 (father).
Availability of cigarettes at home was assessed by six items. Examples are: ‘Do your parents/you have cigarettes freely available at home’ and ‘Do your parents/you hide cigarettes’, with responses 1 ‘never’ to 4 ‘always’. Internal consistencies were 0.84 (adolescent), 0.83 (mother) and 0.83 (father).
Parental norms aimed to assess parental views on adolescent smoking (Flay et al., 1995; De Vries et al., 1996). Two items were employed: ‘Do your parents approve of your smoking or your starting to smoke?’ and ‘Do your parents approve of young people smoking?’. Responses could be given on a five-point scale from ‘probably not’ to ‘probably yes’. Pearson correlations between these two items were 0.69 (adolescent), 0.55 (mother) and 0.76 (father), all Ps < 0.001.
Parental influence on their offspring smoking measured the confidence of respondents that parents are able to influence adolescents’ smoking behavior. The scale consisted of five items. Examples are: ‘Do you think that your parents are able to prevent you from smoking’ and ‘If your parents say that they do not want you to start smoking, do you take any notice of that message’. Responses could be given on a five-point scale from 1 ‘probably not’ to 5 ‘probably yes’, and s were 0.80 (adolescent), 0.80 (mother) and 0.71 (father).
House rules assessed the existence of rules on adolescent and adult smoking at home (seven items). Examples are: ‘I am/my child is allowed to smoke at home’ and ‘It is a rule that someone who wants to smoke, smokes outside home’. Responses ranged from 1 ‘definitely not’ to 5 ‘definitely yes’, with s of 0.78 (adolescent), 0.74 (mother) and 0.76 (father).
Finally, we developed a measure of possible reactions of parents on adolescent experimental smoking and regular smoking. Parents were asked to indicate how they would react when they found out that their child smoked. If the child already smoked, they were asked to report how they reacted when they found out. The six possible reactions were: ‘I would punish him/her/would be very angry/would do nothing at all/would be very disappointed/would discuss it with him/her/would consider it very annoying’. Children were asked to report how they thought their parents would react or reacted. For each of the reactions, respondents had to indicate whether they (or in the case of adolescents answering these questions: their parents) would endorse these reactions, on a scale ranging from 1 ‘definitely not’ to 5 ‘definitely yes’. These six responses had been asked twice. The first time when parents would find out that their child smoked only once (experimented with smoking) and the second time when parents would find out that their child already had smoked for several months.
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Results |
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Comparison of anti-smoking socialization by adolescents and parents
When we compared the responses of parents and adolescents, it appeared that family members provided corresponding answers concerning perceived parental influence, parental smoking norms and availability of cigarettes at home (Table I). The majority of respondents thought that parents indeed have some influence in preventing adolescent smoking. Furthermore, most respondents indicated that parents would disapprove of adolescent smoking and that parents sometimes have cigarettes available at home. With respect to communication about smoking, house rules, parental warnings and monitoring of adolescent smoking, significant differences existed between family members. In general, mothers were more positive on communication about smoking than adolescents and fathers. Surprisingly, adolescents reported significantly higher levels of parental monitoring and presence of house rules than parents did. So, parents may underestimate their anti-smoking socialization efforts or adolescents may overestimate their parent’s efforts with respect to these variables.
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Correlations between anti-smoking socialization behavior and adolescent smoking cognitions
Pearson correlations were computed between indicators of anti-smoking socialization and adolescents’ smoking-related cognitions, self-efficacy, attitudes, susceptibility for peer pressure and intentions to smoke (Table II). Parental reports on anti-smoking socialization and adolescents’ reports on smoking cognitions were used for these analyses.
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Parental reports of their perceived influence on their offspring smoking was strongly associated with adolescents’ smoking cognitions. Parents who think they can affect their children’s smoking behavior were more likely to have children with high levels of self-efficacy, low levels of pro-smoking attitudes, low susceptibility for peer pressure and low intentions to smoke. Parents’ own norms on adolescent smoking were also related to smoking cognitions. Parents who disapprove of adolescent smoking were more likely to have children with high levels of self-efficacy and low pro-smoking attitudes (for fathers’ and mothers’ reports), and low intentions to smoke (mothers’ reports). Furthermore, the frequency of communication on smoking was negatively associated with self-efficacy (for fathers’ and mothers’ reports) and susceptibility for peer pressure (fathers’ reports). This means that parents who often talked with their children about smoking were more likely to have children who were less confident to resist peer pressure to smoke or to not refrain from smoking in the near future. House rules and warnings were associated with smoking attitudes and susceptibility for peer pressure (only fathers’ reports). Availability of cigarettes at home was not associated with adolescent smoking cognitions.
Comparison of adolescent and parental perceptions of reactions to adolescent experimental and regular smoking
Parental reactions to adolescent smoking may affect the likelihood that young people start to smoke. We asked parents to indicate how they thought they would react if they found out that (1) their child was experimenting with smoking or (2) their child had started smoking a few months earlier. In addition, adolescents were asked to indicate how they thought their parents would react in these two situations.
Examination of the answers revealed clearly that most parents as well as adolescents did not think that punishment and anger would be typical parental responses on adolescent experimentation with smoking (see means depicted in Table III). In addition, the majority of respondents did not assume that neglecting smoking would be a typical strategy adopted by parents to cope with adolescent smoking.
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A comparison of the responses between family members showed that there were no differences concerning neglect and disappointment as possible reactions between mother, father and adolescent. However, family members differed with respect to punishment, anger, problem solving and annoyance. Adolescents reported more often that their parents would punish them or would be angry than did their mothers and fathers (only in the case of punishment). In addition, both parents said more often that they would react in a problem-solving manner than adolescents said they did. Adolescents indicated less often that their parents would find it annoying that they smoke than did both parents.
Correlations between parental reactions to adolescent experimental and regular smoking, and adolescents’ intentions to smoke
The relationships between perceived responses to adolescent smoking by both parents and adolescent intentions to smoke were examined as well (see Table IV). The findings demonstrated that perceived punishment was not related to smoking intentions. If the father reported that he would be angry in response to the child’s experimental smoking, it was more likely that his adolescent child would be motivated to start smoking. This association was not found for the mother’s responses. If the mother stated that she would neglect both experimental and regular smoking, her child would be more likely to intend to start smoking. Paternal and maternal disappointment and annoyance were related to adolescent’s smoking intentions. If parents indicated that they would be very disappointed or annoyed, their child would be less likely to intend to start smoking. Finally, if parents (both father and mother) reported that they would discuss their offspring’s smoking behavior with them (problem solving), the adolescent showed less intention to smoke.
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Effects of parental smoking status on anti-smoking socialization behavior
In order to test whether smoking and non-smoking parents differ in anti-smoking socialization, ANOVAs were computed on perceived reactions to adolescent smoking and smoking specific parenting practices with parental smoking status as a within-group factor.
The analyses showed that house rules and availability of cigarettes differed for smoking behavior by parents. In households in which both parents themselves smoked, they had less strict rules on smoking at home (M = 2.22 and M = 2.38, respectively) for reports of father and mother than households in which no parent smoked (M = 3.10; M = 3.34), and similar rules as in households in which one parent smoked (M= 2.19; M = 2.47) [Fmother(2, 97) = 9.47, P < 0.001, Ffather(2, 97) = 11.10, P < 0.001]. Higher availability of cigarettes was more often found in households in which both parents smoked (M = 2.59 and M = 2.47, respectively for reports of father and mother) than households in which no parent smoked (M = 1.08; M = 1.03) and similar rules as in households where one parent smoked [M= 2.23; M = 2.24) [Fmother(2, 97) = 79.32, P < 0.001, Ffather(2, 97) = 71.73, P < 0.001]. No significant differences were found for communication on smoking, warnings, knowledge of the child’s smoking, smoking norms and perceived own influence.
Furthermore, a series of linear regression analyses was conducted with the smoking status of parents and individual anti-smoking socialization behaviors as main effects, and parental smoking status and indicators of anti-smoking socialization as interaction terms. The dependent variable was adolescents’ smoking intentions. We found a significant interaction effect in only one of the 14 analyses, i.e. in the case of maternal norms on adolescent smoking (F change in second step = 4.55, P < 0.05). Parental smoking and maternal norms explained 12% of the variance in smoking intentions, and the interaction term an additional 4%. This implies that, particularly in non-smoking households in which the mother holds negative norms on adolescent smoking, adolescents are less likely to intend to start smoking.
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Discussion |
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In a study among 116 Dutch families in which both parents and one adolescent were interviewed, we explored the ways in which parents influence their children by administration of a battery of questionnaires on anti-smoking socialization.
The correlations between indicators of anti-smoking socialization and smoking cognitions suggest that parents’ opinions and actions do matter. One of the most important findings is that if parents themselves have confidence in the fact that they actually can have some influence on their offspring’s smoking behavior, their children have a lower intention to start smoking. How they exert this influence is less clear. For example, the existence of specific house rules, parental warnings to prevent adolescents smoking and communication on smoking had no relations to adolescents’ intentions to smoke [see also (Henriksen and Jackson, 1998)]. However, monitoring of adolescents’ and their friends’ smoking behavior and smoking norms was indeed related to smoking intentions. When parents believe that they have insight into their offspring’s smoking behavior, and when parents have strong norms against adolescent smoking, their children appear to be less likely to take up smoking.
Jackson and Henriksen (Jackson and Henriksen, 1997) showed that adolescents who expect negative consequences from their parents if they start smoking are less likely to smoke themselves. In the same vein, we asked parents whether they would punish their children or would be angry if their child would start smoking, and associated these responses with adolescents’ intentions to smoke. In contrast to Jackson and Henriksen, we found no significant correlations between these parental reactions and adolescent smoking intentions. So, in our study, punishment and reacting with anger seem to be ineffective ways of dealing with adolescent smoking behavior. Furthermore, neglecting offspring smoking can have a detrimental effect on adolescent smoking intentions, but only for mothers. If mothers indicate that they would neglect adolescent experimental or regular smoking, their children are more likely to intend to start smoking. Nonetheless, talking with children about their smoking behavior, letting their children know that they would be disappointed and that they would find it annoying, seem effective ways to prevent adolescents from taking up smoking.
The present study is one of the first to include three perspectives on anti-smoking socialization—those of the father, mother and child. Other studies have only included adolescents (Jackson and Henriksen, 1997) or one parent (Clark et al., 1999). The results indeed showed significant differences between parents and adolescents with respect to anti-smoking socialization. In some cases, mothers were more positive about their efforts to socialize their children into non-smoking (e.g. communication on smoking at home and the use of warnings) than adolescents. For other types of anti-smoking socialization, such as awareness of adolescent smoking be havior and house rules, adolescents were more positive than mothers. Only in one case did we find a difference between paternal and adolescents reports, i.e. in the case of awareness of adolescent smoking. Fathers were less likely to be aware of their offspring smoking than mothers and also according to the perceptions of adolescents.
Concerning possible reactions to adolescent smoking, it appeared that adolescents were more likely to think that their parents would be angry and would punish them if they were to smoke, and less often thought that their parents would employ a problem-solving strategy or would be annoyed than was actually the case. Furthermore, generally speaking, fathers and mothers do not differ much in anti-smoking socialization when we look at the means on the variables in the study, but also in terms of correlations between measures. Concerning the latter, additional analyses showed that the correlations between paternal and maternal reports of anti-smoking socialization indicators vary between r = 0.33, P < 0.001 and r = 0.93, P < 0.001. Thus, in general, parents seem to be quite similar in their anti-smoking socialization behaviors.
We can assume that parental smoking status influences (1) the extent to which parents are involved in anti-smoking socialization and (2) its effectiveness. Concerning the first, we found differences in the mean levels of some indicators of anti-smoking socialization between households in which one parent smokes, both parents smoke and none of the parents smoke. House rules are less strict and, not surprisingly, the availability of cigarettes is much higher in households in which one or both parents smoke than in non-smoking households. However, no differences were found with respect to perceived own influence on their offspring’s smoking, parental warnings, communication on smoking, smoking norms and awareness of offspring smoking. Furthermore, we also found no differences in the associations between anti-smoking socialization and adolescent intentions to smoke for variations in parental smoking. Earlier studies have shown that smoking parents are less effective in their anti-smoking parenting practices than non-smoking parents (Jackson and Henriksen, 1998; Clark et al., 1999). However, Jackson and Henriksen also clearly showed that even when parents smoke, they could strongly affect their adolescent smoking behavior if they were to employ specific strategies, such as warnings and no-smoking rules. How parental smoking status affects anti-smoking socialization in practice is highly relevant not only for theory, but for practice as well. It is therefore necessary that future studies focus on the longitudinal effects of anti-smoking socialization on adolescent smoking onset, differentiating smoking and non-smoking parents.
Most of the measures of anti-smoking socialization had been developed especially for this research project. This was necessary as there were no scales available to measure different aspects of anti-smoking socialization. The few studies that concentrate on anti-smoking socialization in most cases used single items as indicators of smoking-specific parenting practices. It is therefore important to stress that all scales had satisfactory reliabilities. We have confidence in the estimates of internal consistency since we were able to replicate these estimates in data from three sources, i.e. mothers, fathers and adolescents. However, future research should provide more information regarding the psychometric properties of these scales.
Previous studies were restricted to examining the associations between anti-smoking socialization and adolescents’ intentions to smoke/ actual smoking behavior [e.g. (Jackson and Henriksen, 1997; Clark et al., 1999)]. Since several studies have shown that parents may also indirectly influence adolescents’ intentions and behavior [e.g. (Flay et al., 1994)], it is relevant to examine whether anti-smoking socialization affects adolescents’ attitudes and self-efficacy. In addition, some researchers stress that parents may also affect adolescents vulnerability to peer pressure (Engels et al., 1996, 1999). Our findings underscore the importance of looking at indirect effects. In sum, our findings suggest that further research should concentrate on the relations between anti-smoking socialization and various smoking cognitions.
Some limitations of our study should not go unmentioned. (1) The cross-sectional design of the study does not permit any conclusions about causality. It remains unknown whether specific parental efforts to prevent their offspring from smoking also lead to lower odds of smoking onset in the long run. (2) Although we followed a strategy in which 315 family members provided us with information and perspectives on communication with regard to smoking in their nuclear family, the total number of families that provided data was limited. This small sample size does not allow for analyses in different subgroups, such as gender, educational level and age of the adolescent. One of the aims of this study was to compare reports of the father, mother and child on anti-smoking socialization. We therefore decided to exclude single-parent families (with most often the mother as a single parent in the household).
Finally, for the development of prevention programmes it is essential to know whether anti-smoking socialization reflects general parenting styles or the quality of adolescent–parent relationships. For example, if the absence of anti-smoking socialization is embedded in a climate of conflict and miscommunication between parents and adolescents, one may wonder whether changing parental anti-smoking socialization would be effective. For prevention efforts, it is also important to know when parents should pay attention to their child’s behavior. Should they begin in primary school before most children start experimenting with smoking, or should parents wait until their children reach the age of 12 or 13 when experimentation is more likely. Future research should establish whether early parental interventions have positive effects on children’s smoking in the long run. In The Netherlands, primary prevention efforts focus mainly on the adolescent rather than the parents. Although some written documentation for parents is available and some schools invite parents to visit information sessions on how to deal with smoking, this information is sparse. The current paper makes a start to focus on how parents can prevent their children from smoking. After replicating these findings in larger, more representative samples, interventions oriented to parents can be developed and tested.
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Acknowledgements |
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R. C. M. E. E. was supported by a fellowship of the Dutch Organization of Scientific Research during the preparation of this manuscript. This research was supported by a grant of the Dutch Foundation for Smoking and Health.
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References |
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Received on December 27, 2000; accepted on July 17, 2003
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