Hrubá Drahoslava, Zaloudíková Iva
Department of Preventive Medicine, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Cent Eur J Public Health. 2008 Dec;16(4):178-81. doi: 10.21101/cejph.a3488.
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.
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.
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.
Smoking of family members significantly reduces the efficiency of school educational anti-smoking activities aimed at children and young people.
儿童吸烟的一级预防主要通过由受过培训的教师组织的学校教育计划来开展。普遍接受的观念是，儿童的观点和行为受学校影响，但主要受家庭、同龄人以及更广泛社会的影响。一项针对小学一至三年级的一级预防计划，名为“无烟是常态”，致力于鼓励家长积极参与对孩子的控烟教育以及其他健康生活方式方面的教育。本文分析了记录该计划在儿童家庭吸烟史方面有效性的数据。
在第一阶段和第二阶段（一年级和二年级）开始前的询问过程中收集有关家庭中吸烟者的信息，并在阶段结束后再次收集。在第一阶段，分别跟踪母亲、父亲和祖父母的吸烟情况。在第二阶段，可能影响儿童的吸烟者类别包括与孩子有接触的父母、祖父母、兄弟姐妹、姑姑和叔叔（即所谓的“大家庭”）。不知道父母或祖父母是否吸烟的孩子所回答的问卷被排除在调查之外。分析包括来自该计划组和对照组的1857名儿童中的1423名（即76.6%）。答案进行编码，并使用EPI INFO软件3.3.2版本中的卡方检验进行分析。
约30%的儿童父母吸烟。近60%的儿童受到吸烟的父母和祖父母的影响，超过四分之三的儿童受到“大家庭”吸烟的影响。家庭中吸烟者越多，孩子从小接触香烟和吸烟用具的机会就越多：他们会拿到、购买甚至点燃香烟。父母和其他亲属吸烟导致未来决定吸烟或正在考虑吸烟的儿童数量大幅增加。超过一半的八岁儿童尝过酒精饮料，在吸烟者家庭中更为频繁。8%的八岁儿童已经有过首次吸烟尝试，而且他们都来自有成年吸烟者的家庭。另一方面，受访者吸烟或不吸烟的家庭环境并未影响干预计划的知识部分。在研究组中，与对照组相比，“大家庭”中受吸烟者影响的儿童明显更多（80.1%对73.0%）。这可以解释为什么在不考虑家庭环境的情况下，该计划在知识领域的中期效率评估最高，而观点和行为变化方面的差异大多不显著。
家庭成员吸烟显著降低了针对儿童和青少年的学校教育控烟活动的效率。
