Parent-Daughter Discussions to Discourage Tobacco Use: Feasibility and Content
Ary, Dennis V., James, Lisa, Biglan, Anthony, Adolescence
There is strong and consistent evidence that young women are taking up cigarette smoking at high rates. Seventy percent of high school females report having tried smoking (Centers for Disease Control, 1992a) and 27% report having smoked in the last month (Centers for Disease Control, 1992b). Further, school-based smoking prevention strategies may be failing to influence many young women (Ary et al., 1990; Biglan, Glasgow, et al., 1987; Biglan, Severson, et al., 1987). Clearly, new methods are needed.
Parents have been found to influence their children's tobacco use by serving as models of the behavior (Allegrante et al., 1977; Banks et al., 1978; Bauman et al., 1990; Bewley, 1978; Borland & Rudolph, 1975; Chassin et al., 1986; Hansen et al., 1987; Murray et al., 1985; Pederson & Lefcoe, 1982; Palmer, 1970; Pederson et al., 1981; Williams, 1973), by condoning tobacco use (Friedman et al., 1985; Leventhal et al., 1988), and possibly by providing access to tobacco. There is also evidence that intervention programs that include parental components can have beneficial effects on children's health behavior, such as cigarette smoking and substance use (Johnson et al., 1990; Worden et al., 1987) and other risks to cardiovascular health (Nader et al., 1989; Perry, Luepker, et al., 1989). However, parent-adolescent discussions about tobacco use may cause conflict. For example, Hops et al. (1990) found that young people who were more prone to substance use were also more prone to get into arguments when discussing smoking and other substance use. A further concern is that parents may not be receptive to written advice regarding discussions with their children about tobacco use.
Research is limited on the optimal content of effective parent-daughter discussions about tobacco use. Thus, the goals of the present study were: (1) to develop a pamphlet that could guide parents in talking to their daughters about tobacco use, (2) to examine the extent to which parent-daughter interactions were aversive, (3) to determine parent receptivity to the pamphlet, (4) to solicit input from parents and daughters on improving the content of the intervention materials, and (5) to learn more about intervention strategies that might prevent tobacco use among young women.
The study was conducted in small communities in Oregon. With the cooperation of the school district, recruitment letters were mailed to parents of all 6th- and 8th-grade females, who were offered $15 for their participation ($30 per dyad). Twenty-one females in grade 6 and 23 in grade 8, along with 41 mothers and 3 fathers, consented to participate.
Development of the Parent Pamphlet Intervention
Development of the pamphlet was guided by previous work (Bry, 1988; D'Onofrio, 1991; Hawkins et al., 1985; Pentz et al., 1989; Perry, Klepp, & Sillers, 1989; U.S.D.H.H.S., 1990) and by focus groups with parents and daughters. The following themes were included: setting clear family expectations and rules regarding tobacco use, the advertising tactics of the tobacco industry that target youth, the consequences of tobacco use, facts about chewing tobacco, praising a daughter for not using tobacco, tips for parents who use tobacco themselves, and developing a family agreement (written) about nonuse of tobacco.
Parents were asked to read a pamphlet designed to encourage effective communication with their children about tobacco. The parent-daughter dyads then had an audiotaped conversation in which feelings about tobacco use were discussed. Parents were told that they could use ideas from the pamphlet in their conversation, but that discussion of the pamphlet was not required. Parents could keep and refer to the pamphlet during their talk if they wished. Afterward, both daughter and parent completed questionnaires pertaining to the tobacco discussion.
Parent questionnaire. …