The Influence of Parental Smoking on Youth Smoking: Is the Recent Downplaying Justified?

Article excerpt

Parental smoking has emerged as a significant influence on youth smoking in a variety of studies. Smoking by parents has been shown to be a significant, general factor promoting youth smoking,[1,2] strongly affecting elementary[3] and school-age youth, exerting greater influences than peer smoking[4] and socioeconomic status,[5] and even displaying continuing, although lesser, effects on smoking by teens as old as college age.[6] A recent study rating parental attitude toward smoking as more important than parental smoking behavior, nonetheless found that children of smoking parents who disapproved of smoking were more likely to smoke than children of nonsmoking parents who did not disapprove of smoking.[7] That "75% of all teen-age smokers come from homes where parents smoke"[8] and "smoking habits of children are highly correlated with smoking habits of parents"[9] was accepted official wisdom until the mid-1980s.

However, parental smoking recently has been down-played as health lobbyists increasingly emphasized influences external to the home. The 1994 U.S. Surgeon General's report, Preventing Tobacco Use Among Young People, did not mention parental smoking as a factor in youth smoking and devoted only one sentence to dismissing the issue.[10] Yet studies emphasizing alternative motivators, such as tobacco advertising[11,12] and peer pressures,[13] have been mixed or inconclusive, especially as to generality of effect,[14] and typically do not examine the competing hypothesis and context of parental smoking.

Have things changed? Should health educators regard parental smoking as trivial in the decision of youth to smoke today? Does parental smoking affect the response of students to school health promotion? The following discussion examines these questions for younger students, age 1015, in health classes in four northern Los Angeles junior high schools.

THE LOS ANGELES SURVEY

Prior to an anti-smoking presentation by Jerry and Sharon Anderson of the American Cancer Society, a brief, anonymous baseline survey on smoking was administered to students in health classes at four northern Los Angeles junior high schools in spring 1993. The survey obtained basic demographic information and asked if neither, one, or both parents smoked, whether the youth had ever smoked,had smoked during the past week, or had smoked during the past 24 hours, and whether the youth would, might, or would not smoke in the future. Of 410 surveys distributed, 407 completed baseline surveys were returned; three were discarded due to incompleteness.

Students in classes with 320 students then immediately heard an anti-smoking presentation by the Andersons. The presentation featured a talk by Jerry Anderson, whose larynx was removed due to smoking-induced cancer. Students and teachers reported strong emotional reaction by students to seeing the prominent hole in his throat and to his electronically enhanced speech. After the talk, students immediately were re-administered the same survey they completed approximately 45 minutes earlier. In addition, classes containing the other 90 baseline-surveyed students were resurveyed at the end of their class without hearing an anti-smoking presentation. These "control" classes were surveyed before the Andersons' presentations to later classes to prevent their influence by test students discussing the presentation with classmates.

Examination of baseline data showed the test and control classes did not differ significantly, although racial makeup differed to some extent. Surveys were tabulated and analyzed using standard chi-square analysis of observed versus expected frequencies across the demographic, parental smoking, youth smoking, and anti-smoking presentation variables. Because of the difficulties inherent in this and other self-reporting surveys, noted later, a stricter critical (alpha) standard of .01, rather than the conventional .05, is used in reporting significant associations. …