PREVENTING INITIATION OF SMOKING BY CHILDREN

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Youth who first smoke cigarettes during childhood are at high risk for subsequent addiction to tobacco, and youth whose parents smoke cigarettes are at high risk for early initiation of cigarette smoking. Few programs are available that aim to prevent initiation of smoking during childhood, and none is available that aim to prevent early initiation by engaging parents who smoke in altering children's smoking-specific socialization. This project tests an innovative program to change smoking-specific socialization of children in households where parents smoke cigarettes. Aim 1: During the childhood years, through communication, modeling, role setting, monitoring, guided experience, and other socialization practices, parents influence their children's perceptions of the prevalence of smoking, the acceptability of smoking, the accessibility of cigarettes, and the personal and social consequences of smoking. A premise of this research is that all parents, including parents who smoke, can engage in anti-smoking socialization, and that anti-smoking socialization can lower children's risk of smoking. Components of a home-based anti-smoking socialization program specifically for parents who smoke have already been developed. The proposed project will finalize development of this program by incorporating information from a completed feasibility study conducted with 122 parents who smoke. Aim 2: A randomized controlled study will test the effects of anti-smoking socialization on children's susceptibility to and initiation of cigarette smoking. Sample: A nonprobability sample of 864 mother-child pairs will be recruited, where inclusion criteria specify that mothers, step-mothers, or other maternal figures from single or two-parent households who have male or female children who will be in the 3rd grade at baseline are eligible. Design: Eligible pairs who complete the badeline survey will be randomly assigned to the treatment (anti-smoking socialization program) or control condition. Follow-up data on program implementation will be obtained via telephone interviews from mothers I month post-treatment. Follow-up data on program effects will be obtained using surveys administered at school to children at 12, 24, and 36 months post-baseline. Hypothesis: Children exposed to a grogram of anti-smoking socialization by mothers who smoke will be less susceptible to smoking and report less initiation of smoking than unexposed peers. Analyses: A later transition model will be used to test the effects of anti-smoking socialization on children's susceptibility to cigarette smoking. Survival analysis will be used to test the effects of anti-smoking socialization on children's initiation of cigarette smoking.