Most adults who smoke started smoking as teenagers.[269] Smoking by peers, siblings and parents has consistently been demonstrated to increase the risk of smoking.[269, 381, 382]
Additional evidence since 2004
Adolescents who smoke become dependent quite rapidly on tobacco-delivered nicotine.[383-385]
School-based programs
After decades of effort pursuing tobacco education in schools, fewer than half of the published studies of rigorously designed trials show evidence of short-term effects, and almost none have demonstrated long-term effects.[386]
A peer-led intervention (ASSIST), focusing on training opinion-leading teenagers in persuasion techniques for use when talking to their peers about smoking outside the classroom,[387] has recently demonstrated promising results.[388, 389] This approach is worth monitoring.
Family programs
Parents who smoke can socialise their children against smoking,[390] but family-based programs aiming to discourage smoking have been only modestly successful[391] and would be difficult to deliver population-wide. Such programs have rarely involved siblings.
What parents can do
There is much that parents can do to discourage their children from taking up smoking.
Lead by example
Young teenagers with one or more parents who smoke are more than three times more likely to experiment with smoking, and older teenagers are almost three times more likely to smoke regularly than the teenagers of parents who do not smoke. 12-15-year-olds 16-17-year-olds
Figure 21: Proportion of students who were never smokers, experimental smokers or current smokers among students with no, one or two parents who smoke, 12-15-year-olds and 16-17-year-olds, Victoria, 2005 - no parent, one parent or two parents smoking
Analysis of data on smoking among Year 10 students in New Zealand in 2007 compared with 2001 has shown that the decline in smoking prevalence has been greatest for students with no parents smoking and least for students with both parents smoking (Table 7b of the NZ report).[393] Quitting by parents has a very strong effect on subsequent smoking by children, and is probably the single most important thing that a smoker-parent can do to prevent their children from taking up smoking.[394]
An Australian longitudinal study shows that children of non-smokers are also more likely to remain non-smokers in the long term.[395] Smoking by children is also highly related to sibling smoking, and older teenagers often state that they hope their younger siblings do not experiment with smoking: siblings may be an untapped resource for tobacco control.[396, 397]
Go smoke-free
US studies[398, 399] find that even after controlling for demographic factors and parents' smoking status, children who lived in homes where smoking was banned were more than 20% less likely to take up smoking than children who lived in homes where smoking was allowed. However, there is little evidence that educational interventions can encourage the adoption of smoke-free homes.[400]
Be a strong family
Children who spend more time with their families and deal effectively with conflict are less likely to take up smoking: eating dinner together most nights really does seem to be a very good idea![401] Lack of parental supervision is also strongly associated with smoking experimentation.[392] Top of Page
Progress in Australia
The websites of state Quit campaigns suggest that they continue to provide information and resources to schools. Little information is available about the reach of programs at the school or individual level.
Bans on smoking in shopping centres and the widespread adoption of smoke-free homes must make it increasingly difficult for children to experiment with smoking undetected by parents. Evaluation of the 2001 Parents campaign (featuring a young girl recounting a recent event to her dying father: 'You should have been there, Dad'), and focus group and tracking research on the WA Cancer Council's testimonial advertisement depicting a real smoker talking about her fears about what will happen to her children when she dies,[402] suggests that narrative adverts can have a strong impact with low SES parents.
Action proposed Continue to monitor and keep abreast of findings of studies assessing the impacts of interventions aimed at teenagers outside the classroom, particularly those involving siblings and those focused on disadvantaged groups.
Given the likely impact on both parents and children, Quit campaigns should see parents as an important target group for advertising.
The Centre for Behavioural Research in Cancer to include in future reports of ASSAD the long-term trends for teenagers (in each major category of smoking status), whether parents smoke and whether their homes are smoke-free.