Intervention to Prevent Onset of Smoking in Childhood

描述（由申请人提供）：开始吸烟在当前不吸烟者的儿童中很普遍，并且在青春期后期显著增加发展为习惯性吸烟的几率。我们需要适合儿童的预防计划，由父母在家中实施，并将重点放在反吸烟社会化上，作为防止开始吸烟的工具。目的1：设计并制作一种干预措施，使目前不吸烟的父母能够与他们8岁的孩子一起参与反吸烟社会化活动。干预将运用沟通、建模、规则制定、监测、指导经验和其他社会化实践来改变儿童对吸烟流行程度、吸烟可接受性、香烟可及性以及吸烟对个人和社会后果的看法。目的二：进行两组随机对照试验来检验干预措施。样本：志愿者样本为760名来自单亲或双亲家庭，年龄在8岁，在基线时处于开始吸烟前阶段的男女儿童，由不吸烟的母亲、继母或其他女性监护人组成。设计：该研究将跟踪8 - 11岁（3 - 6年级）的儿童，以衡量反吸烟社会化对吸烟相关结果的影响。完成基线调查的符合条件的参与者将被随机分配到治疗组（核心项目加两次年度强化治疗）或替代对照组。在治疗后1个月，通过与家长的电话访谈获得核心项目使用情况的数据。项目效果的数据将通过对基线后12、24和36个月儿童的电话访谈获得。主要假设：目前不吸烟者的孩子在8岁开始接受反吸烟社会化计划后，开始吸烟的可能性明显低于11岁的对照组。次要假设：在最终随访期间保持戒烟的儿童中，接受干预的儿童对吸烟的易感性明显低于对照组。初步分析：生存分析将检验反吸烟社会化对开始吸烟的影响。二次分析：比例优势模型将检验反吸烟社会化对最终随访中戒烟儿童吸烟易感性的影响。

DESCRIPTION (provided by applicant): Initiation of cigarette smoking is prevalent among children of current nonsmokers and it significantly increases the odds of progression to habitual smoking by late adolescence. Prevention programs are needed that are appropriate for children, designed to be implemented at home by parents, and focused on anti-smoking socialization as a tool for preventing initiation of smoking. Aim I: Design and produce an intervention that enables parents who are current nonsmokers to engage in anti-smoking socialization with their 8 year old children. The intervention will apply communication, modeling, rule setting, monitoring, guided experience, and other socialization practices to modify children's perceptions of the prevalence of smoking, the acceptability of smoking, the accessibility of cigarettes, and the personal and social consequences of smoking. Aim II: Conduct a two-group, randomized controlled trial to test the intervention. Sample: A volunteer sample of 760 male and female children from single or two-parent households who will be 8 years old and in the pre-initiation stage of smoking at baseline will enroll with a nonsmoking mother, step-mother, or other female guardian. Design: The study will follow children from ages 8 through 11 (grades 3 through 6) to measure the effects of anti-smoking socialization on smoking-related outcomes. Eligible participants who complete the baseline survey will be randomly assigned to the treatment (core program plus two annual boosters) or alternative control condition. Data on core program utilization will be obtained via telephone interviews with parents 1 month post-treatment. Data on program effects will be obtained via telephone interviews with children 12, 24, and 36 months post-baseline. Primary hypothesis: Children of current non-smokers exposed to a program of anti-smoking socialization beginning at age 8 will be significantly less likely to initiate smoking than controls by age 11. Secondary hypothesis: Among children who remain abstinent to final follow-up, those exposed to the intervention will have significantly lower susceptibility to smoking than controls. Primary analysis: Survival analysis will test the effects of antismoking socialization on initiation of smoking. Secondary analysis: A proportional odds model will test the effects of anti-smoking socialization on susceptibility to smoking among children abstinent at final follow-up.