Zaloudíková Iva, Hrubá Drahoslava, Samara Ibrahim
Department of Psychology, Faculty of Education, Masaryk University, Brno, Czech Republic.
Cent Eur J Public Health. 2012 Mar;20(1):38-44. doi: 10.21101/cejph.a3652.
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.
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.
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.
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.
社会影响是与儿童及青少年吸烟相关的最重要因素之一。家庭、同龄人群体、专业及市政社区中的社会规范通过主要由互动和观察获得的社会化过程影响个体。特别是家庭吸烟限制所体现的家庭环境社会背景,是一种劝阻吸烟的社会化机制。父母的反吸烟社会化行为(他们对儿童吸烟的态度和知识、以适当质量和频率讨论吸烟、家庭吸烟环境)受其教育程度和家庭状况影响。
在对参与“无烟即正常”项目队列中的五年级学生进行访谈时,调查了社会环境指标(母亲和父亲的教育程度、家庭状况)。考虑了关于在家中和汽车中自我报告的被动吸烟暴露数据。从766名11岁儿童那里获取了与父母讨论吸烟的情况、对成年人吸烟的看法、吸烟尝试以及未来吸烟的同时期决定等信息。那些不知道父母教育程度或家庭状况的儿童被排除在评估之外。在统计软件Epi Info 6版中使用卡方检验、Mantel-Haenszel检验、Fisher检验和Yates校正检验评估差异。
母亲和父亲的教育程度显著影响儿童的被动吸烟暴露。与父母受高等教育的家庭相比,父母教育程度为中等和低等的家庭中的儿童在家中和汽车中暴露于环境烟草烟雾的情况显著更多(相对危险度1.38;95%可信区间1.04 - 1.83),且他们中生活在无烟环境中的较少。在整个队列中,67.5%的儿童甚至从未吸过一口烟,17.2%报告有过一次尝试,15.4%反复吸烟。父母的教育程度对儿童当前的吸烟尝试或他们未来吸烟的同时期决定没有影响。从父母那里获得香烟的儿童数量与父母的教育程度也没有差异(约6%)。当将母亲的教育程度与家庭状况相结合时,发现了显著差异。与与父母双方(母亲受高等教育)共同生活的儿童相比,其他群体的儿童更常报告当前有吸烟尝试,且决定未来不吸烟的人数较少。在所分析的社会家庭群体的儿童之间,在其他知识和态度指标方面未发现显著差异。
在我们的研究中,父母的教育程度显著影响儿童在家中和汽车中的被动吸烟暴露,但对儿童对吸烟的看法和态度没有影响。母亲的高等教育和家庭状况显著降低了与父母双方(母亲受高等教育)共同生活的家庭中儿童当前吸烟尝试的频率和未来吸烟的决定。有必要寻找提高父母对预防吸烟关注的方法。