Tobacco use, the leading cause of premature death and disability in the United States, is a significant family issue. Parental smoking negatively impacts children's health and increases their risk of becoming smokers; concerns about children are often cited as strong motivators for parental smoking cessation. Additionally, smoking parents do not want their children to smoke, yet are not confident they can prevent it. Children, aware of the harms of smoking, display negative behaviors, such as nagging and policing, towards the smoking behavior of adult loved ones. Proposed are pilot research activities to develop an innovative family-based intervention to encourage more effective communication and interactions between children and adult loved ones who smoke. The overarching objectives of the intervention are to increase adults' effectiveness in discouraging children from smoking and reciprocally, to increase children's effectiveness in encouraging adults to take steps towards smoking cessation.
The specific aims are to: 1) develop a prototype of a self-directed intervention composed of activities to be engaged in together by third through fifth graders and chosen adult loved ones who smoke; 2) evaluate the most effective methods of recruitment, surveying and retention of participant dyads; 3) evaluate compliance with and short-term indicators of efficacy of the intervention. Focus groups with children and adult smokers will be conducted to guide development of the intervention materials. Draft intervention materials will be reviewed by representatives of the target groups using structured interviews. Fifty adult-child dyads will be recruited from a variety of community sources, with documentation of the success associated with each recruitment source. Thirty-five dyads will be randomized to receive the intervention and 15 to a no-intervention condition. Baseline and 4 month follow up surveys will be completed by all 50 dyads at survey centers located at familiar community facilities. Surveys will assess susceptibility to uptake of smoking among the children, type and level of motivation for cessation and cessation attempts among the adults; and communication about smoking for both the adults and children. Compliance with and response to the intervention will be assessed among those randomized to the intervention condition.
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