Parenting styles, screen time impact childhood smoking rates

A global scientific review finds that good, old-fashioned parenting trumps school intervention programs for effectiveness.

March 19, 2015

The best way to lower smoking rates among kids is by implementing deterrent strategies at home, along with some good old-fashioned parenting, says a University of Calgary researcher behind a global scientific review.

“Focused, engaged parents, and parents with the help of experts, were more effective than school intervention programs,” at preventing children from taking up smoking, said Dr. Roger Thomas, review lead, O’Brien Institute for Public Health researcher, and professor in the Department of Family Medicine.

“School-based intervention programs were 12-per-cent effective, while the benefits of home-based intervention programs seem to be between 16- and 32-per-cent effective. The school interventions which taught social skills to refuse cigarettes were ineffective, but school interventions that taught social competence or social competence plus social skills were effective,” Thomas explained.

“In Canada, rates of smoking in adults are at the lowest level in years through control efforts and people quitting. However, preventing addiction in the first place, especially during childhood, is critical to living a smoke-free life.”

The findings from the review — which was undertaken by researchers from the O’Brien Institute, the Cumming School of Medicine, and Australia’s Queensland University of Technology — have just been published in the Cochrane Library of the Cochrane Collaboration, a world-wide independent network of health practitioners, researchers, patient advocates and others from 120-plus countries preparing high-quality information to support health decisions.

Smoking rate for Canadian males is up significantly from 2009

According to 2010 figures compiled by Statistics Canada, six million (20.8 per cent of the population) Canadians aged 12 and older smoked either daily or occasionally — 24.2 per cent of males and 17.4 per cent of females. For males, this was a significant increase from the 22.6 per cent recorded in 2009. For females there was no change from 2009.

Smoking is a risk factor for lung cancer, heart disease, stroke, chronic respiratory disease, and other chronic diseases, added the agency.

A majority of adult smokers started the habit as children and the literature review showed that, although not perfect, the best tool at society’s disposal in curbing uptake in the first place is home-based initiatives, said Thomas.

“Most adult smokers started smoking as children or adolescents. We found that many try smoking as early as eight years of age. Most of them obtained cigarettes in the home, and smoked if the parents weren’t engaged or the children weren’t supervised,” he explained.

“Most children will try their first cigarette at the age of 11 or 12.”

Authoritative parenting the most successful at deterring childhood smoking

As a result of those stats, most of the antismoking programs identified through his review, were school- or home-based. Home-based-programs focused on providing parents with tools or guidance about styles of parenting. From the data they collated, Thomas and his team uncovered that it was authoritative parenting that was the most successful.

“The more intense the intervention, the better the outcome. But the intervention had to be of an authoritative nature, not authoritarian,” said Thomas.

Authoritative parents, he explained, were intensely involved in their kids’ lives, made quality family time a priority, engaged their kids socially, monitored their children’s activities and social efforts, and set boundaries, such as staying on top of their online activities, and setting limits on screen time.

Authoritarian parents — of the ‘do as I say’ ilk — on the other hand, did not achieve such results, said Thomas.

Smoking is a leading preventable cause of death in Canada

According to a 2012 tobacco use study authored by the University of Waterloo, of the estimated 4.7 million dedicated smokers in Canada, up to half will become ill or die from continued tobacco use. A leading preventable cause of death in Canada, tobacco kills more than 37,000 people annually and is responsible for approximately one third of cancers in the country.

Meanwhile, its economic impact is also significant, with an estimated social cost of $17 billion per year. “Recent estimates indicate that tobacco‐related illness costs Canadians $4.4 billion in direct health care costs, and is responsible for 2.2 million acute care hospital days,” states the report.

In their study, Family-based programmes for preventing smoking by children and adolescents, Thomas and his colleagues also found that no investigative work is being done at the family level in Canada, Africa or Asia. As well, Thomas says, although much of the fundamental information needed to create an effective intervention has already been gathered in the U.S. and Europe, there’s little communication or collaboration between researchers tackling the problem.

“So, the strategy (to curb rising smoking rates) now is for groups of researchers to get together and decide which is the most powerful intervention, and develop it further,” he said.

“Our review demonstrates an opportunity for families, the community and the government to invest in family programs which offer a lifetime benefit.”

The research team examined 27 randomized controlled studies of over 36,000 participants. Fourteen of the studies reported measures of smoking which enabled meta-analysis, a research technique to combine studies for a larger, more powerful conclusion. Twenty-three of the trials were from the U.S., two from Europe, one from India and one from Australia.

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