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Úvod: V rozvinutých zemích je expozice dětí zakouřenému ovzduší v bytech jedním z nejzávažnějších zdravotních rizikových faktorů. Ve školním výchovném programu "Normální je nekouřit" je zahrnuta i aktivní spolupráce rodičů s cílem podpořit jejich dobrovolné vytváření nekuřáckých domovů. Účinnost programu byla testována v pilotní studii na 10 základních školách v Brně a Frýdku-Místku a následně v širší studii na 25 základních školách z Brna, Zlína, z okresních i menších měst Čech a Moravy, které měly o program zájem; k nim byly přiřazeny školy kontrolní ze stejných lokalit. Metody: Během pětileté prospektivní semilongitudinální studie byli rodiče opakovaně informováni o hlavních tématech programu a žádáni o spolupráci při některých domácích úkolech. Předmětem domácích úkolů byly diskuse o zdravotních následcích kouření a typech závislosti, zařazení tělesné aktivity do každodenního rozvrhu dětí, přijetí doporučení ke zdravé výživě. Každoročně byly u rodičů sledovány jejich znalosti, názory a úroveň expozice dětí pasivnímu kouření pomocí krátkých anonymních dotazníků. V poslední etapě byly porovnávány údaje získané od 266 rodičů dětí s programem, odlišených, zda tolerují, či netolerují kouření v bytech, použitím statistického programu EPI INFO. Výsledky: Významně méně rodičů tolerujících kouření v bytech bylo informováno o zdravotních rizicích kouření (46,9 % vs. 70,8 %, p<0,001), o vysokém riziku závislosti (57,8 % vs. 79,7 %, p<0,01) a o významu kouřících členů rodiny pro iniciaci kouření u dětí, pro které jsou špatným vzorem (12,5 % vs. 23,3 %, p<0,05). Tito rodiče byli také častěji skeptičtí k prevenci (29,7 % vs. 12,9 %, p<0,05) a méně z nich hovořilo s dětmi o kouření (76,6 % vs. 88,6 %, p<0,05). Rodiče podhodnocovali kouření v bytech, jejich děti až dvakrát častěji uváděly tento zdroj znečištění domácího ovzduší. Jen 3,4 % rodičů změnilo dřívější toleranci ke kuřákům na striktní pravidla "domovů bez kouře". Téměř 11 % rodičů uvádělo zanechání kouření v průběhu studie hodnotící působení programu. Závěr: Program měl jen malý vliv na znalosti a názory rodičů o kouření a na vytváření nekuřáckých domovů pro jejich děti.

Introduction: In developed countries, child exposure to tobacco smoke at home poses a major health risk. In the school-based educational programme "Non-Smoking is normal", active parental cooperation is requested for the purpose of creating voluntary smoke-free homes. The effectiveness of the programme was tested both in the pilot study involving 10 primary schools in Brno and Frýdek Místek, and in the wider study that comprised 25 primary schools in Brno, Zlín, and smaller regional towns involved in the project. A further 25 schools from the same localities were taken as a control. Methods: During the five-year follow-up semi-longitudinal study, parents were repeatedly informed of the main themes of the programme and asked for participation in several tasks. The objectives of these home tasks were discussion about the health consequences of smoking and types of dependence, as well as inclusion of physical exercise as part of the children' daily schedule and adoption of dietary guidelines. Every year, a short anonymous questionnaire testing knowledge, opinions and the level of children' exposure to passive smoking was sent to participating parents. In the last stage of the programme, data obtained from 266 parents of children was processed using EPI INFO software. Results: Significantly less parents who tolerated smoking at home were well informed about the health hazards of smoking (46.9% vs. 70.8%, p<0.001), about the high risk of addiction (57.8% vs. 79.7%, p<0.01), and about the role of smoking family members as bad role models (12.5% vs. 23.3%, p<0.05). These parents were also more often sceptial on the issue of prevention (29.7% vs. 12.9%, p<0.05) and fewer of them discussed the subject of smoking with their childrenl (76.6% vs. 88.6%, p<0.05). Parents underestimated the effects of smoking at home, and only 3.4% of parents changed their prior tolerance to smokers in order to adopt strict smoke-free rules at home. Almost 11% of parents reported cessation of smoking during the period of the study. Conclusion: The programme had only a limited impact on the opinions, attitudes and behaviour of parents participating in the Non-Smoking is Normal programme.

Kapitola

Prevence kouření ve škole

Závislost na tabáku. 2013 ; () : 155-162.

ISBN 978-80-904217-4-5
Medvik
Zdroj

MeSH
dítě MeSH
kouření cigaret * prevence a kontrola MeSH
lidé MeSH
mladiství MeSH
podpora zdraví metody organizace a řízení MeSH
předškolní dítě MeSH
prevence kouření metody organizace a řízení MeSH
školy MeSH
zdravotní výchova metody MeSH
Check Tag
dítě MeSH
lidé MeSH
mladiství MeSH
předškolní dítě MeSH

Kniha

Příklady dobré praxe programů školní prevence rizikového chování

Praha : Klinika adiktologie, 1. lékařská fakulta Univerzity Karlovy v Praze a Všeobecná fakultní nemocnice v Praze ve vydavatelství Togga, 2012

Monografie

Vydání první 173 stran : ilustrace ; 25 cm

Článek

What limits the effectiveness of school-based anti-smoking programmes?

Central European Journal of Public Health. 2012 ; 20 (1) : 18-23.

Cent. Eur. J. Public Health
ISSN 1210-7778
Medvik
Zdroj

Backround: It is generally accepted that living in families where there are smokers, children are stressed not only by the harmful physical exposure to second-hand and third-hand tobacco smoke, but also by the negative models of the adult relatives' behaviour, as relatives who smoke can inspire children to imitate this behaviour, influencing attitudes towards, and early experiments with smoking. In this paper, some of the most important results about influence of family smoking on the effects of the anti-smoking educational programme "Non-smoking Is Normal" are described. Methods: The school-based programme was created by medical and educational specialists and targets children at the first level of primary schools (aged from 6 to 11 years). The data about interesting outcomes of the programme (knowledge, attitudes, behaviour) were collected by anonymous questionnaire, administered twice in each school year: one month before the complex of 5 lectures (pre-tests) and 4–5 months after the last lecture (post-tests). The sample of participants (860–910) was divided into four groups, according to the intervention and family backrounds: (1) programme children from smoking families "P–S"; (2) control children from smoking families "C–S"; (3) programme children from non-smoking families "P–NS"; (4) control children from non-smoking families "C–NS". The differences in the frequency of children's answers were analysed using the tests in statistic Epi Info software, version 6.04a (chi-square, Mantel Haenszel, Yates, Fisher). Results: In the programme group, the number of children with smoking relatives was significantly higher than in the control group (80.1% vs. 73.0%, p<0.01) as well as of those who reported frequent/daily exposure to secondhand smoke at homes and/or in cars (49.5% vs. 40.0%, p<0.01). Smoking families significantly influenced the children's seeking of smoking friends (40% vs. 17%, p<0.01). The programme has significantly increased the amount of knowledge about health risks of smoking. Both in the programme and control groups of children from non-smoking families, the frequency of critics of adults smoking was significantly higher all the time of the study (p<0.05 and 0.01 resp.); however, the programme influenced children's opinions about smoking (criticism) only partially. Children's actual intentions about their smoking in the future was fully influenced by their smoking household environment: the number of "future no-smokers" has decreased in time and was significantly less frequent among children from smoking families (p<0.01). The frequency of those willing to smoke significantly increased within the period between 3rd and 5th grades, both in the programme and the control groups (p<0.01). An almost linear increase of active experimentations with cigarette smoking in follow-up monitoring was seen, trends of smoking children were steeper in groups from smoking families. The number of experiments with smoking was significantly lower in programme children of non-smoking parents only at the end of the study (p<0.05). Conclusions: Despite of the effort to initiate parental participation on the primary prevention of smoking, we have confirmed that smoking in families decreased the efficacy of anti-smoking intervention targeted on young children at school age.

MeSH
dítě MeSH
kouření MeSH
lidé MeSH
prevence kouření MeSH
rodina MeSH
sexuální faktory MeSH
školy organizace a řízení MeSH
úmysl MeSH
vystavení vlivu životního prostředí MeSH
zdravé chování MeSH
zdraví - znalosti, postoje, praxe MeSH
zdravotní výchova organizace a řízení MeSH
Check Tag
dítě MeSH
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
práce podpořená grantem MeSH
Geografické názvy
Česká republika MeSH

Článek

Parental education and family status – association with children's cigarette smoking

Central European Journal of Public Health. 2012 ; 20 (1) : 38-44.

Cent. Eur. J. Public Health
ISSN 1210-7778
Medvik
Zdroj

Background: Social influences are among the most important factors associated with children's and adolescents' smoking. Social norms in families, peer groups, professional and municipal communities influence the individuals ones by the process of socialization obtained mainly by interactions and observations. Especially social context of the home environment expressed by household smoking restriction serves as a socialization mechanism that dissuades from the using of tobacco. Parental anti-smoking socialization practices (their attitudes and knowledge about children smoking, discussion about smoking in appropriate quality and frequency, smoking environment in homes) are influenced by their education and family status. Methods: Markers of social environment (the level of mothers' and fathers' education, family status) were investigated during interview with 5th graders included in the cohort participating in the programme "Non-smoking Is Normal". Data about the self-reported exposure to passive smoking at homes and cars were taken into consideration. Information about discussions with parents about smoking, opinions about adults smoking, experimentation with smoking, and concurrent decision about smoking in the future were obtained from 766 children aged 11 years. Those who did not know parental education or family status were excluded from the evaluation. Differences were evaluated using the chi-square, Mantel-Haenszel, Fisher and Yates corrected tests in the statistic software Epi Info, version 6. Results: The level of mothers' and fathers' education significantly influenced the exposure of children to passive smoking. Compared to families of higher educated parents, children living in families with middle and low levels of parents' education were significantly more exposed to environmental tobacco smoke at home and in car (RR 1.38; 95% CI 1.04–1.83) and fewer of them live in non-smoking environments. In the whole cohort, 67.5% children have not smoked even one puff yet, 17.2% reported one single attempt, and 15.4% smoked repeatedly. The level of parents' education had no influence on children's concurrent smoking experimentation or on their concurrent decision about smoking in the future. There was also no difference in number of children who obtained cigarettes from their parents and parents' level of education (about 6%). When the level of maternal education was combined with the family status, significant differences were found. Compared to children living with two biological parents (highly educated mother), children from other groups more often reported current experimentating with smoking and lower number of those decided not to smoke in the future. No significant differences were found in other markers of knowledge and attitudes between children from analysed social family groups. Conclusion: In our study, the parental education has significantly influenced exposure of children to passive smoking at homes and in cars, but had no effect on children's opinions and attitudes about smoking. Higher education of mothers and family status significantly lowered the frequency of current experimentation and decision about future smoking among children living in families with two biological parents of whom mother attained higher education. It is necessary to seek ways for improving parental concern about smoking prevention.