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.

• MeSH
• dítě MeSH
• kouření epidemiologie   MeSH
• lidé MeSH
• rodina * MeSH
• sociální prostředí MeSH
• stupeň vzdělání MeSH
• zdraví - znalosti, postoje, praxe MeSH
• znečištění tabákovým kouřem statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• znečištění tabákovým kouřem MeSH

BACKGROUND: 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
• 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
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

UNLABELLED: This study, aimed at the primary prevention of smoking behaviour in children and adolescents, attempts to find the main factors that distinguish smokers and non-smokers in the period of their first experimentation with cigarettes. There are only a few studies dealing with investigations into current motivations of teenagers as to whether or not to smoke. The programme entitled "Normal is not to smoke", using evaluation questionnaires given to children in the 3rd and 5th classes, also contains--among many other things--specifics on reasons children have for making the decision whether to become a smoker or non-smoker. The results are reported in this paper. METHODOLOGY: Responses concerning potential inclination to smoking that were collected from children on the basis of questionnaires were categorized into the following groups: image, the influence of a role model, the effects of smoking, curiosity. Reasons for non-smoking were categorized into the following groups: health, aesthetic, economic, restrictive, other aspects. Children were also asked to describe smokers by using three pairs of opposite characteristics: education, success, wealth. The frequencies of answers were analysed for the whole set, for boys and girls and for children with different smoking behaviour; the differences were evaluated using the statistical programme EPI INFO, version 6. RESULTS: A total of 1153 children in the 3rd class and 799 children in the 5th class completed the questionnaire. Motivations for smoking were given by nearly 17% of children in the 3rd class and by nearly 27% of the same cohort in the 5th class. Aspects such as image (41.9% vs. 46.2%) were mentioned most frequently, by boys more frequently than by girls (OR 1.77; 95% CI 0.93-3.36; p = 0.06), by children from smokers' families more frequently than by children from non-smokers' families (OR 1.33; 95% CI 0.69-2.57; p = 0.3) and more frequently by children with repeated attempts to smoke (OR 3.93; 95% CI 2.32-6.65) or children who had only had a single smoking attempt (OR 3.18; 95% CI 1.52-6.75). Also the role of models (parents, relatives, friends) was often mentioned (12.9% in the 3rd class and 10.2% in the 5th class). Potential beneficial effects of smoking were expressed by 13% of children in the 3rd class and by 55% of children in the 5th class (p < 0.0001). About 40% of children considered smoking as effective coping with stress and about 20% of them declared smoking for mood improvement. Beneficial effects of smoking significantly more often described children with repeated smoking attempts (OR 2.91; 95% CI 1.73-4.89; p < 0.001). Children often linked smoking to the less educated and less successful social groups but also to the rich. In both investigations, health aspects were the most common reasons for choosing not to smoke (69.2% vs. 73.3%), being more frequently presented by girls and non-smokers. A significant shift in the negative aesthetic perception of smoking (14.1% in the 3rd class vs. 40.2% in the 5th class) and economic disadvantages of smoking (3.9% vs. 24.8%) was observed in the given period of time. Restrictive reasons were given only rarely by pupils in the 3rd class (0.7%), unlike pupils in the 5th class who feared the reaction of their parents (24.8%). CONCLUSION: Our study provides an overview of current motivations in children aged 9 and 11 years that are crucial for their future smoking/nonsmoking behaviour. The results of the study are important for developing a strategy for the primary prevention of smoking in school programmes and for introducing a general social approach to address the problem of the decreasing age of smoking initiation.

• MeSH
• chování dětí psychologie   MeSH
• dítě MeSH
• kouření psychologie   MeSH
• lidé MeSH
• motivace MeSH
• rodina MeSH
• rozhodování * MeSH
• sebepojetí MeSH
• sociální prostředí MeSH
• socioekonomické faktory MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: For the majority of smokers, smoking is related to other forms of risk behaviour, especially poorer eating habits. The primary preventive educational programme "No smoking is a norm" focuses on children of younger school age (under 10 yrs), enables comparison and statistical evaluation of whether there are any differences (and which) between ten-year-olds with various smoking experiences, with special attention paid to their exposure to the influence of smokers, and their eating habits. METHODS: Analysis of data gained from a questionnaire compared groups of boys and girls, smokers and non-smokers, and children from families with no smokers, occasional smokers, and frequent smokers. Statistical significance of the differences was tested in the EPI INFO programme by means of the chi2 test. RESULTS: From 1,082 children, almost one quarter (22.9%) have already tried smoking, boys more frequently (25%) than girls (19%) (p < 0.05); and almost 7% smoked repeatedly. The household is the most frequently stated environment for accessing cigarettes in children: 51% of children are given cigarettes by their parents, siblings, grandparents or other relatives, another almost 17% take cigarettes themselves from unprotected stock. From 246 children who have smoked, more than one third were offered cigarettes by their friends, and some (4%) even bought them. Children with smoking experience more often come from smokers' families and more often have smoking siblings and friends who offer them cigarettes. Children claimed to have consumed alcoholic drinks over the past month, repeatedly smoking more often than those with one attempt (aprox. 81% vs 58%) and never smokers (32%). Smokers also more frequently ate salty snacks such as crisps, sausages, and fast foods. The circumstance of whether there are smokers in the child's household or not significantly influenced children's opinions on the smoking of men/boys and women/girls (fewer critics and more admirers in smokers' families), selection of friends, availability of cigarettes, and smoking behaviour of the children. CONCLUSION: The examination of a cohort of ten-year-olds in a semi-longitudinal study confirmed the growing trend of experimenting with smoking. Strong relations to smoking behaviour in families were identified--such that influence a more tolerant approach to parents' smoking, selection of smoking or non-smoking friends, more frequent consumption of alcohol and salty snacks.

• MeSH
• chování dětí * MeSH
• dítě MeSH
• kouření epidemiologie   psychologie   MeSH
• lidé MeSH
• prevalence MeSH
• rodina * MeSH
• vyrovnaná skupina MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• životní styl MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: Primary prevention of smoking in children is mostly carried out through school education schemes organised by trained teachers. The generally accepted notion is that children's opinions and behaviour are influenced by the school, but mainly by the family and their peers, as well as by the broader society. The primary preventive programme aimed at the first three years of primary schools, called "No Smoking is a Norm" strives to encourage parents to take an active part in the education of their children against smoking, as well as about other aspects of a healthy lifestyle. This paper analyses the data documenting the effectiveness of the programme with respect to children's family smoking history. METHODS: The information about smokers in families was collected during enquiries prior to the initiation of the 1st and 2nd stage (in the 1st and the 2nd class), and again after their conclusion. In the first stage, smoking of mothers, fathers, and grandparents was followed separately. In the second stage, the category of smokers that can influence children, included parents, grandparents, siblings, aunts, and uncles, with whom the children are in contact (the so-called "broader family"). Questionnaires answered by children who did not know whether their parents or grandparents smoked were excluded from the survey The analysis included 1423 (i.e., 76.6%) from the total number of 1857 children from the programme and control groups. The answers were coded and analysed using the chi2 test in EPI INFO software, version 3.3.2. RESULTS: Approximately 30% of the children's parents are smokers. Almost 60% of the children were exposed to the influence of smoking parents and grandparents, and more than three quarters of the children experienced smoking from the "broader family". The more smokers there are in the family, the more children have the opportunity to handle cigarettes and smoking accessories from an early age: they get, buy, or even light cigarettes. Smoking of parents and other relatives led to a substantial increase in the number of children who were determined to smoke in the future or were considering it. More than half of the eight-year-olds have tasted an alcoholic drink, and significantly more frequently in the families of smokers. 8% of the eight-year-olds have gone through their first smoking attempts and all of them from families with adult smokers. On the other hand, the smoking or non-smoking family environment of the respondents did not influence the knowledge part of the intervention programme. In the study group, in comparison with the control group, there were significantly more children exposed to the influence of smokers in the "broader" family (80.1% vs. 73.0%). This could explain why evaluation of the medium-term efficiency of the programme without consideration of the family environment was highest in the knowledge area, while differences in change of opinions and behaviour were mostly insignificant. CONCLUSIONS: Smoking of family members significantly reduces the efficiency of school educational anti-smoking activities aimed at children and young people.

• MeSH
• chování dětí etnologie   psychologie   MeSH
• dítě MeSH
• dospělí MeSH
• hodnocení programu MeSH
• kouření epidemiologie   psychologie   MeSH
• lidé MeSH
• prevence kouření * MeSH
• primární prevence metody   normy   MeSH
• průzkumy a dotazníky MeSH
• rodina etnologie   psychologie   MeSH
• školní zdravotnické služby organizace a řízení   normy   MeSH
• sociální konformita MeSH
• sociální žádoucnost MeSH
• vztahy mezi rodiči a dětmi etnologie   MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• zdravotní výchova metody   normy   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky kontrolované MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH