Parental smoking behavior and a number of general parenting practices have been associated with the probability that an adolescent will become a.smoker. Early adolescence appears to be an optimal developmental time for targeting parental practices to reduce adolescent problem behavior. The proposed study is a randomized, controlled trial of a telephone counseling intervention designed to affect parenting practices previously demonstrated to influence a dolescent smoking. Working with 2000 families with 12-14 year old adolescents, this intervention seeks to adapt an effective school-based program (The Adolescent Transition Program--ATP) into a community setting, using a computer assisted telephone counseling structured protocol. We have previously demonstrated that this type of telephone counseling is an effective way to influence other types of health behavior. Both the ATP and our other telephone counseling programs are based on the principles of cognitive social learning theory and motivational interviewing. We will enroll households from a population-based representative survey of Californians. Intervention goals are that parents will maintain general protective parenting practices, such as monitoring and setting limits to autonomy within a responsive relationship with the adolescent through at least age 16 years. Further, the intervention will encourage parents actively partner with the California Tobacco Control Program in promoting nonsmoking norms and nonsmoking environment, and in increasing the rate of adoption of tobacco control related practices including, a) communicating strong parental expectations against smoking behavior, b) establishing a smoke-free home, c) monitoring and intervening when peers use or promote the use of tobacco, and d) promoting demand reduction strategies to reduce adolescent receptivity to tobacco industry promotional activity. The primary assessment of adherence to the intervention in both study groups as well as the effectiveness in changing smoking behavior will come from annual surveys of adolescents. Using these data, we will identify whether the intervention is associated with a significant reduction in the proportion of 15-16 year old adolescents who have experimented with smoking, as well as a reduction in the probability that they will be future dependent smokers. We will use surveys of both adolescents and parents to describe the natural history of protective parenting during the adolescent years. We will identify factors associated with these general protective parenting practices and barriers to implementing these practices. The surveys will also allow us to describe the natural history of how parents implement optimal tobacco control parenting practices, identify potential barriers to such practices, and develop potentially effective ways for overcoming these barriers.
