Intervention to Prevent Onset of Smoking in Childhood

描述（由申请人提供）：开始吸烟在目前不吸烟的儿童中很普遍，它显著增加了青春期后期发展为习惯性吸烟的几率。预防计划需要适合儿童，由父母在家中实施，并侧重于反吸烟社会化，作为预防开始吸烟的工具。目标一：设计并制作一个干预措施，使目前不吸烟的父母能够与他们8岁的孩子进行反吸烟社会化。干预措施将采用沟通、建模、规则制定、监测、指导经验和其他社会化实践，以改变儿童对吸烟流行率、吸烟的可接受性、香烟的可及性以及吸烟的个人和社会后果的看法。目的二：进行两组随机对照试验，以测试干预措施。样品：来自单亲或双亲家庭的760名男性和女性儿童的志愿者样本将与不吸烟的母亲、继母或其他女性监护人一起入组，这些儿童将年满8岁，在基线时处于开始吸烟前阶段。设计图：该研究将跟踪8至11岁（3至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。完成基线调查的合格参与者将被随机分配到治疗组（核心计划加两次年度加强剂）或替代对照组。将在治疗后1个月通过电话采访父母获得核心计划利用率数据。将通过对基线后12、24和36个月的儿童进行电话访谈获得有关项目效果的数据。主要假设：目前不吸烟的儿童在8岁时开始接受反吸烟社会化计划，到11岁时开始吸烟的可能性明显低于对照组。次要假设：在最终随访时保持戒烟的儿童中，那些接触干预措施的儿童对吸烟的易感性将显著低于对照组。主要分析：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：比例优势模型将测试反吸烟社会化对最终随访时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.