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Family factors in smoking acquisition among Latino youth

Institution: San Diego State University Research Foundation
Investigator(s): Rafael Laniado-Laborin, M.D., MPH
Award Cycle: 1998 (Cycle 7) Grant #: 7RT-0049 Award: $865,636
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
In focus groups with Latino youth, we learned that some parents were prompting their children to engage in behaviors that put them in direct contact with cigarettes or, without meaning to, encouraged them to "practice" smoking-relating behaviors. The most direct of these parental prompts was to ask a child to light the cigarette in their mouth and then pass it to the parent. Survey results showed that, among children with smoking parents, 17% of Mexicans, 18% of Mexican-Americans. and 3% of other U.S. ethnic groups reported this parental prompting behavior. In addition, children who more frequently reported lighting cigarettes in their mouths also more frequently reported that they smoked.

The proposed study of parental prompts to smoke will focus on Latino youth and their families in San Diego. The purposes of this three-year proposed study are to validate children's reports of parental prompting with parents' reports, to identify what parental characteristics are associated with prompting and to see if children who report parental prompts early in the study are more likely to become smokers. In Phase I, separate focus groups will be held with Latino parents who smoke and their children (average age between 13-14 years). Based on focus group results, survey items will be developed to assess (a) parent and child reports of parental prompting behaviors and (b) parent and child perceptions of potentially effective intervention strategies.

Phase II will consist of student surveys and parent interviews to assess: a) initial smoking behavior among children; b) children's reports of parental prompting; c) parent's reports of parental prompting; d) agreement between child and parent reports of parental prompts; and e) factors associated with parental prompting. A total of 600 families will participate. Families will have at least one smoking parent and one child in the 7th or 8th grade. Surveys will be completed in schools by children to collect information on parental prompting, child's smoking behavior and to identify participants for parent interviews. Target families who are identified will be invited to participate in an interview related to parental prompting and factors related to parental prompting. Incentives will be offered to smoking parents who complete the survey. Possible factors related to parental prompting, include parent sex, parent attitude toward child smoking, how often parents smoke, parent knowledge of tobacco effects, parent exposure to anti-smoking information, and how acculturated parents are to the American culture.

In Phase III, a one-year follow-up of the children will be conducted to examine parental prompting as a predictor of the child's smoking acquisition. Researchers will survey most children in their schools about their tobacco use. If students have moved. other methods will be used to contact them and collect the data. Data will be analyzed to find out if students have started smoking and if parental prompting or sex of the child is related to the students' having started to smoke.

The results of this study will document the incidence of parental prompting of child smoking, and will examine to what extent such prompting leads children to start smoking. In addition, this study will determine whether programs are needed to reduce parental prompting behaviors and what types of programs appear to be most promising and acceptable to Latino parents and children. This study will provide important information about ways to reduce tobacco use among Latino youth.

Final Report
This multi-phase study examined youth and parent reports of parental prompting with prompts ranging from empty or clean ashtrays to smoking with the parent. For the youth study 3624 7th and 8th grade middle school students completed surveys. About 300 smoking parents completed surveys to identify parent-reported factors associated with parental prompting behaviors, with about 30% of parents reporting having prompted their children with at least one of the prompts. One year later, children of the 300 smoking parents and about 300 additional children who reported having no parent smokers in the initial surveys, completed follow-up surveys. Initial findings indicated that parental prompts were less prevalent than in our previous work. We also found that there were not consistent or great differences in the prevalence of prompting between Latinos and non-Latinos and that parental prompting, particularly requests that the child light the parent’s cigarettes with a match or lighter was associated with children’s smoking. Further, we found that Latino adolescents may be influenced by more parental prompts than non-Latinos, and finally that higher familism scores were significantly associated with lower risk of smoking, regardless of ethnicity. Concordance of child and parent reports regarding prompting showed that except for requests from fathers to smoke together, child-reported prompting prevalence was consistently higher than parents’ reports and the biggest discrepancies between parent and child reports were requests to clean ashtrays and bring cigarettes, the two most common prompts. This study also demonstrated a temporal relationship in the multiethnic sample of adolescents between availability of cigarettes and subsequently trying smoking. In this sample, social sources were clearly more important than commercial sources both cross-sectionally and prospectively. In the prospective study, parental prompts were not related to subsequent adolescent trial smoking among 478 multi-ethnic adolescents. The result was unexpected, since our previous cross-sectional studies had shown several strong and consistent associations.
Publications

Availability of cigarettes as a risk factor for trial smoking in adolescents
Periodical: American Journal of Health Behavior Index Medicus:
Authors: Woodruff SI, Candelaria JI, Laniado-Laborin R, Salllis JF, & Villasenor A ART
Yr: 0 Vol: Nbr: Abs: Pg:

Parental prompting and smoking among Latino youth.
Periodical: Ethnicity and Disease Index Medicus:
Authors: Laniado-Laborin R, Woodruff SI, Candelaria JI & Sallis FJ ART
Yr: 0 Vol: Nbr: Abs: Pg: