Tsu-Suan Wu and Benjamin W. Chaffee, DDS, PhD, of the University of California, San Francisco, advised in their study in Pediatrics.
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Previous studies have shown that children who grow up in a nonsmoking household are less likely to begin smoking themselves, and active parental engagement in interventions shows promise overall in protecting children from drug, alcohol, and illicit drug use. Households with rigid rules against smoking offer a deterrent for children who might otherwise be tempted, the researchers noted.
Other studies have shown that while youth smoking is on the decline, use of noncigarette products is increasing sharply. The inconspicuous appearance and attractive scents these delivery devices afford make it easier to conceal them from parents.
In the current study, using data from the Population Assessment of Tobacco and Health (PATH) Study involving 23,170 parents and youth ages 9 and up, Mr. Wu and Dr. Chaffee sought to assess to what extent parents had knowledge or suspicions of tobacco use and also to evaluate the association between youth initiating tobacco use and the establishment of household rules and engaging in regular conversation about tobacco.
Study results revealed in three of the four groups evaluated that youth were most likely to engage in using several different types of tobacco (polytobacco) products; in the fourth group, e-cigarette use was most common. Among polytobacco users, fully 77%-80% reported cigarette usage.
Parental knowledge and actions
Overall, Mr. Wu and Dr. Chaffee “identified substantial lapses in parents’ awareness of their children’s tobacco use.” Parents were most likely to register awareness when their children smoked cigarettes; half as many parents were aware or suspected use when noncigarette products were used.
Parents who had heightened awareness about possible tobacco usage tended to be the child’s mother, had completed lower levels of education, parented children who were older, male and non-Hispanic, and lived with a tobacco user.
Noteworthy was the growing percentage of parents who report awareness or suspicions of cigarette usage – approximately 70% – compared with previous study findings – about 40%. The researchers speculated that this increase could be directly tied to growing social concern regarding youth smoking. Unfortunately, parents will continue to be challenged to keep up with constantly changing e-cigarette designs in maintaining their awareness, Mr. Wu and Dr. Chaffee noted.
Establishing strict household rules was found to be more effective than just talking with youth about usage, which half of the youth reported their parents did. At all time points, the risk of tobacco initiation was 20%-26% lower for children who lived in a house with strict household rules forbidding any tobacco use by anyone. The researchers observed that success with the household rules method was best achieved with children at younger ages.
The study did not measure the quality or frequency of antitobacco conversations but it should not be concluded definitively that all parental communication is unhelpful, the researchers cautioned.
To their knowledge, this study is the first to analyze the effects of household antitobacco strategies on discouraging initiation the use of tobacco and other smoking products as well as assessing parental awareness surrounding tobacco usage among youth.