Williams CL, Strobino BA, Ibanez C, Liebmann-Smith J
Summary:
What Do Preschool Children Think About Cigarettes and Smoking? Knowledge, Attitudes, and Future Smoking Intentions:The Healthy Start Project
C.L. Williams, MD, MPH; B.A. Strobino, MPH, PhD; C. Ibanez, MA; and J. Liebmann-Smith, PhD
Background:
Research suggests that children begin to learn about smoking in the first few years of life. Preschoolers become aware of smoking, learn to recognize smoking products and logos, acquire a vocabulary that includes smoking words and products, form attitudes about smoking and smokers, and think about whether they want to smoke in the future. The present survey was designed to assess smoking knowledge, attitudes, and future smoking intentions in a population of preschool children, as well as to evaluate the effect of parental smoking on the latter.
Methods:
A predominantly low-income, minority sample of preschool children were interviewed in 1997 with a 13-item computer-assisted survey instrument to assess smoking knowledge, attitudes, presence of smokers in the child’s home, and future intentions to smoke cigarettes.
Results:
A total of 503 children participated in the survey; 46% thought it was “cool” to smoke and 57% said they intended to smoke in the future. When asked about individuals in their household, 69% reported that they lived with a smoker. The frequency distribution of the nature of the relationship of the smoker to the child was as follows: 35% mother, 21% father, 15% both parents, and 29% other or unspecified smoker. Odds ratios comparing intention to smoke by presence or absence of parental smoking, and positive or negative attitudes toward smoking revealed that smoking intentions were significantly influenced by parental modeling. The odds ration for a future intention to smoke was 6.7 (95% CL = 3.7, 12.0) among children of smoking mothers compared to children living in homes with no smokers. The odds ratios were somewhat less for children living in homes where the father was the only smoker 3.5 (95% CL = 1.9, 6.6) or homes where both parents smoked 2.7 (95% CL = 1.3, 5.3). Children who thought smoking was “cool” had significantly greater future intention to smoke than those who did not have this perception (P < 0.001). Two-thirds of the children identified “Joe Camel” as a smoker, although the picture contained no cigarettes.
Conclusions:
In Summary, a significant proportion of preschool children recognize cigarettes, associate Joe Camel with smoking, think smoking is “cool,” and have future intentions to smoke, especially if their parents or other household members smoke. These findings reinforce the importance of parental involvement in youth tobacco prevention programs, to increase awareness of the powerful influence parents have over children’s health attitudes and behaviors, and to actively facilitate parental smoke cessation.
CVD Prevention 2000; 3:235-241
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