Smoking-specific communication and children's smoking onset: an extension of the theory of planned behaviour

The aim of this study was to test whether maternal smoking-specific communication and parental smoking related to smoking cognitions (i.e. attitude, self-efficacy and social norm) derived from the Theory of Planned Behaviour in association with smoking onset during preadolescence. A total of 1478 pairs of mothers and children participated (mean age: 10.11; standard deviation = 0.78). Structural equation models in Mplus were used to examine whether smoking-specific communication influences children's smoking cognitions, which in turn, affect smoking onset. A positive association was found between pro-smoking attitudes and smoking onset. Smoking-specific communication and parental smoking were related to smoking cognitions. Specifically, frequency of communication was negatively associated with pro-smoking attitudes, social norms of mother and best friend. Quality of communication related negatively to pro-smoking attitudes and positively to self-efficacy and norms of friends. Parental smoking was positively associated with pro-smoking attitudes and norms of mother and (best) friends. Additionally, more frequent communication and higher levels of parental smoking were associated with higher smoking onset. In conclusion, smoking-specific communication and parental smoking were associated with smoking cognitions and smoking onset. Already during preadolescence, parents contribute to shaping the smoking cognitions of their children, which may be predictive of smoking later in life.     

Parenting style and adolescent smoking cognitions and behaviour

Parenting style and smoking-related cognitions have both successfully predicted adolescent smoking behaviour. Data were collected among 482 Dutch adolescents to examine whether effects of parenting styles (authoritative, permissive, authoritarian, rejecting, neglecting, measured by underlying dimensions support, strict control, and psychological control) on adolescent lifetime smoking were mediated by cognitions (pro-smoking attitude, social norm, self-efficacy, intention) and to study the role of gender in this process. Support was not significantly associated with smoking behaviour. The inverse relation between strict control and smoking was partly mediated by attitude and intention, both associated with increased smoking. Psychological control related directly to increased lifetime smoking. Combinations of dimensions creating the specific styles were not associated with cognitions or behaviour. Maternal and paternal parenting were equally associated with smoking cognitions and behaviour; nor were effects moderated by adolescent gender. Interventions to prevent adolescent smoking initiation should aim at increasing strict control and reducing psychological control.     

The relation between smoking-specific parenting and smoking trajectories of adolescents: How are changes in parenting related to changes in smoking?

In this study, we tested to what extent smoking-specific parenting and changes in parenting are related to adolescents’ smoking trajectories. Data were used from a four-wave prospective study including 428 adolescents (aged M = 15.2; SD = 0.60). Latent Class Growth Analyses were conducted to identify trajectories. Multinomial Logistic Regression Analyses were executed to examine the relations between parenting and class membership. Longitudinal cross-lagged models were tested to examine causal predominance between parenting and smoking. Four trajectories were found, consisting of Non-smokers, Increasers, Stable smokers and Decreasers. Quality of parental smoking-specific communication was strongly related to the membership in different trajectories. Along with the cross-lagged associations demonstrating that the quality of communication was predominantly related to future smoking rather than vice versa, these findings indicate that parents who talked about smoking in a constructive and respectful manner were more likely to have non-smoking children. In contrast, parents who talked often about smoking-related issues and increased these discussions over time were more likely to have smoking children; cross-lagged associations indicated that these findings could be best explained by children changing their parents. Having a non-smoking agreement was related to a lower risk in becoming a regular smoker.     

Parental communication appears not to be an effective strategy to reduce smoking in a sample of Dutch adolescents

This longitudinal study examined the reciprocal effects of the frequency of parent–adolescent communication on tobacco-related issues (smoking-specific communication), and adolescents’ smoking. Participants were 428 Dutch older and younger siblings between 13 and 16 years old. Smoking-specific communication did not affect youth smoking in general; however, among younger, but not older, siblings, smoking-specific communication was associated with a higher likelihood of smoking over time. In addition, when adolescents already smoked parents started to talk more frequently about smoking-related issues with their older and younger adolescents later on. Neither the quality of smoking-specific communication, the quality of parent–adolescent relationship, nor parental smoking moderated these reciprocal effects. In conclusion, prevention campaigns encouraging parents to undertake smoking-specific communication might not be desirable.     

The role of risk perception in explaining parental sunscreen use

Objective: This study assessed: (1) whether risk perceptions about skin cancer were related to parent's use of sunscreen on their children; (2) which combination of assessments susceptibility and severity best explain parental sunscreen protection behaviours and (3) whether risk perceptions influence behaviour directly through intentions or through attitudes, subjective norms and self-efficacy. Design: Two longitudinal studies assessed sunscreen protection behaviours of parents for their toddlers (N?=?391) and young children (N?=?436). Main outcome measure: Parent's use of sunscreen on their children. Results: Risk perceptions correlated with future sunscreen protection behaviours of parents but were lower than those of attitude, social influence and self-efficacy. Treating susceptibility and severity as an additive function resulted in the best model fit. Risk perceptions were related with future intention and future sunscreen protection behaviour, but the effects were mediated through attitude, social influence and self-efficacy. Conclusions: Our path analyses suggest treating susceptibility and severity as an additive function. A multiplicative model without main effects - although often used - had the poorest fit. Risk perceptions influence behaviour by influencing attitudinal and self-efficacy beliefs. Addressing risk perceptions in health communication programs is relevant when the purpose is to increase awareness and to influence attitudes and self-efficacy.     

After-School Supervision, Psychosocial Impact, and Adolescent Smoking and Alcohol Use in China

We examined effects of self-care after school hours and psychosocial factors on cigarette smoking and alcohol use among adolescents in China. Survey data were obtained from 4734 7th and 11th grade students from seven cities across China. Students were queried about the frequency and quantity of unsupervised self-care after school in an average week. Tobacco and alcohol usage were also obtained. Odds ratios were calculated to determine the strength of association between unsupervised self-care after school and substance use. Results indicated that the amount of self-care after-school (how many days and how many hours per week) was significantly associated with increased risk for smoking and alcohol use among Chinese adolescents. These associations remained significant even after controlling for anxiety, depressive symptoms, and peer influence. The interaction between unsupervised self-care after school and peer influence indicated that unsupervised self-care after school is a stronger risk factor for smoking among adolescents with pro-smoking friends. The findings suggest that substance use prevention programs for youth in China should try to enhance parental monitoring. As it may not be feasible for families to revert to a lifestyle that includes supervision by relatives, other approaches such as organized after-school care are worthy of consideration.     

The role of risk perception in explaining parental sunscreen use

Objective: This study assessed: (1) whether risk perceptions about skin cancer were related to parent's use of sunscreen on their children; (2) which combination of assessments susceptibility and severity best explain parental sunscreen protection behaviours and (3) whether risk perceptions influence behaviour directly through intentions or through attitudes, subjective norms and self-efficacy.

Design: Two longitudinal studies assessed sunscreen protection behaviours of parents for their toddlers (N?=?391) and young children (N?=?436).

Main outcome measure: Parent's use of sunscreen on their children.

Results: Risk perceptions correlated with future sunscreen protection behaviours of parents but were lower than those of attitude, social influence and self-efficacy. Treating susceptibility and severity as an additive function resulted in the best model fit. Risk perceptions were related with future intention and future sunscreen protection behaviour, but the effects were mediated through attitude, social influence and self-efficacy.

Conclusions: Our path analyses suggest treating susceptibility and severity as an additive function. A multiplicative model without main effects – although often used – had the poorest fit. Risk perceptions influence behaviour by influencing attitudinal and self-efficacy beliefs. Addressing risk perceptions in health communication programs is relevant when the purpose is to increase awareness and to influence attitudes and self-efficacy.     

Prevalence,Correlates and Perceptions Towards Cigarette Smoking Among Male and Female in School Adolescents (Aged 11–18 Years) in South Africa: Results from the 2008 GYTS Study

The aim of this study was to estimate the prevalence and identify correlates of current cigarette use among 8,470 school-going adolescents (aged 11 to 18 years) in South Africa. A cross-sectional study was carried out in 2008 in South Africa within the framework of the Global Youth Tobacco Survey (GYTS). Overall prevalence of current cigarette smoking was 16.5%. Significantly more males (22.8%) than females (10.5%) were current smokers (p < .001). Cigarette smoking among boys and girls was positively associated with parental and/or peer smoking and greater risk perception, and among girls smoking attitudes variables (having more friends among girls, greater attractiveness of boys and weight change) and various higher exposure to smoking advertising and promotion activities were positively associated with cigarette smoking. However, antismoking advertising and community and family education were positively associated with current smoking, while only having school or community special groups or classes for students who want to stop smoking was protective of smoking. Cigarette smoking and other tobacco use is a significant public health problem in South Africa. Public health efforts aimed at preventing adolescent cigarette/tobacco use should incorporate knowledge on the associated factors related to smoking.     

Home-based smoking prevention program Smoke-free Kids on smoking-related cognitions: Secondary outcomes from a cluster randomized controlled trial

Objectives: The home-based smoking prevention programme ‘Smoke-free Kids’ did not have an effect on primary outcome smoking initiation. A possible explanation may be that the programme has a delayed effect. The aim of this study was to evaluate the effects on the development of important precursors of smoking: smoking-related cognitions.

Methods: We used a cluster randomised controlled trial in 9- to 11-year-old children and their mothers. The intervention condition received five activity modules, including a communication sheet for mothers, by mail at four-week intervals. The control condition received a fact-based programme. Secondary outcomes were attitudes, self-efficacy and social norms. Latent growth curves analyses were used to calculate the development of cognitions over time. Subsequently, path modelling was used to estimate the programme effects on the initial level and growth of each cognition.

Results: Analyses were performed on 1398 never-smoking children at baseline. Results showed that for children in the intervention condition, perceived maternal norms increased less strongly as compared to the control condition (β = ?.10, p = .03). No effects were found for the other cognitions.

Conclusion: Based on the limited effects, we do not assume that the programme will have a delayed effect on smoking behaviour later during adolescence.     

Social activities, self-efficacy, game attitudes, and game addiction

This study examines whether social activities with parents, online and offline social self-efficacy, and attitudes toward gaming are associated with the degree of game addiction among adolescents. Using data from a survey of 600 middle- and high-school students in South Korea, we tested the relationships of personal characteristics (grade point average and time spent on gaming each day), social self-efficacy (both on- and offline), general social activities (with parents, friends, and teachers), gaming activities with parents, and attitudes toward gaming (those of self, parents, friends, and teachers) with the degree of game addiction. In addition, we conducted ANOVA tests to determine the differences among three groups: non-addicts (NA), possible (mild or moderate) addicts (PA), and Internet addicts (IA). The results show that social self-efficacy in the real world (offline) was negatively related with the degree of game addiction, whereas social self-efficacy in the virtual world (online) indicated a positive association. Social activities with parents are negatively associated with game addiction, although no relationship is found between gaming activities with parents and game addiction. Parental attitude toward gaming has a negative relationship with the addiction. Results and implications are discussed.     

Smoking is ok as long as I eat healthily: Compensatory Health Beliefs and their role for intentions and smoking within the Health Action Process Approach

Compensatory Health Beliefs (CHBs) are defined as beliefs that the negative consequences of unhealthy behaviours can be compensated for by engaging in healthy behaviours. CHBs have not yet been investigated within a framework of a behaviour change model, nor have they been investigated in detail regarding smoking. Thus, the aim of this study was to investigate on a theoretical basis whether smoking-specific CHBs, as a cognitive construct, add especially to the prediction of intention formation but also to changes in smoking behaviour over and above predictors specified by the Health Action Process Approach (HAPA). The sample comprised 385 adolescent smokers (mean age: 17.80). All HAPA-specific variables and a smoking-specific CHB scale were assessed twice, 4 months apart. Data were analysed using structural equation modelling. Smoking-specific CHBs were significantly negatively related to the intention to stop smoking over and above HAPA-specific predictors. Overall, 39% of variance in the intention to quit smoking was explained. For the prediction of smoking, CHBs were not able to explain variance over and above planning and self-efficacy. Thus, smoking-specific CHBs seem mainly important in predicting intentions but not behaviour. Overall, the findings contribute to the understanding of the role of smoking-specific CHBs within a health-behaviour change model.     

Are smokers interested in genetic testing for smoking addiction? A socio-cognitive approach

Genetic advances have made genetically tailored smoking cessation treatments possible. In this study, we examined whether smokers are interested in undergoing a genetic test to identify their genetic susceptibility to nicotine addiction. In addition, we aimed to identify socio-cognitive determinants of smokers’ intention to undergo genetic testing. Following the protection motivation theory (PMT), we assessed the following constructs using an online survey among 587 smokers: threat appraisal (i.e. susceptibility and severity), fear, coping appraisal (i.e. response efficacy and self-efficacy), response costs and intention. In addition, knowledge, social norms and information-seeking behaviour were measured. Mean intention rates were 2.57 on a 5-point scale. Intention was significantly associated with threat appraisal and coping appraisal, as predicted by the PMT. Fear of the outcome was negatively associated with the intention to undergo genetic testing, but response costs, knowledge and social influence were not. Intention to undergo genetic testing in turn was positively related to seeking information about genetic testing and genetically tailored smoking cessation treatments. Smokers seem ambivalent or ‘on the fence’ with regard to undergoing a genetic test for smoking addiction. Socio-cognitive concepts such as susceptibility, severity, response efficacy and self-efficacy may be used to inform or educate smokers about the value of genetically tailored smoking cessation treatments.     

Effects of parental job insecurity and parenting behaviors on youth’s self-efficacy and work attitudes

Drawing on the spillover mechanism, the relationships among parental job insecurity, authoritarian parenting behaviors, youth’s self-efficacy, and work attitudes were examined. Specifically, parental job insecurity was hypothesized to be positively associated with (1) authoritarian parenting behaviors, and (2) youth’s perception of parental job insecurity. In turn, we hypothesized that both authoritarian parenting behaviors and youth’s perceptions of parental job insecurity were negatively associated with youth’s self efficacy. Finally, self-efficacy was predicted to be positively associated with youth’s work attitudes. Data were collected from 178 management undergraduates and their parents. Structural equation modeling results suggested that paternal job insecurity was positively associated with authoritarian parenting behaviors while maternal job insecurity was negatively associated with authoritarian parenting behaviors. Additionally, while the relationship between mothers’ authoritarian parenting behaviors and youth’s self-efficacy was supported, the relationship between fathers’ authoritarian parenting behaviors and youth’s self-efficacy was not. Youth’s self efficacy was positively associated with their work attitudes. Implications of the findings are discussed.     

Anger and effortful control moderate aggressogenic thought–behaviour associations

The effects of anger and effortful control on aggressogenic thought–behaviour associations were investigated among a total of 311 Finnish fifth and sixth graders (mean age = 11.9 years). Self-reported aggressive cognitions (i.e., normative- and self-efficacy beliefs about aggression) were expected to be associated with higher peer-reported aggressive behaviour. Teacher reported anger and effortful control were hypothesised, and found, to moderate the effects of aggressive cognitions on aggression, such that the effects were strongest for children who were high in anger and low in effortful control, as compared to other conditions. Furthermore, under the conditions of high anger and high effortful control, self-efficacy was negatively related to aggression. Thus, aggression is a result of a complex, hierarchically organised motivational system, being jointly influenced by aggressive cognitions, anger and effortful control. The findings support the importance of examining cognitive and emotional structures jointly when predicting children’s aggressive behaviour.     

Psychosocial predictors of delay of first sexual intercourse by adolescents.

This investigation predicted adolescents' delay of intercourse onset from attitudes, social norms, and self-efficacy about refraining from sexual intercourse. Age, gender, ethnicity, and parental education were also examined as predictors and moderators of the relationships among the 3 psychosocial determinants and onset. The participants (N = 827), part of a cohort initially surveyed in the 9th grade, reported at baseline that they had never engaged in intercourse. The multivariable proportional hazards regression model suggested that adolescents with more positive attitudinal and normative beliefs, as well as those with a parent who graduated from college, were less likely to engage in intercourse in the follow-up period (up to approximately 2 years). Interventions that include an objective to delay onset may benefit from addressing psychosocial determinants, especially attitudes and norms about sexual intercourse.     

The Verbal Summator and a Method for the Study of Latent Speech

Three age groups of children (7-8-, 10-11-, and 13-14-years) were administered a questionnaire dealing with their smoking experiences and attitudes and beliefs about cigarette smoking. The results indicated that the vast majority of children recognized the harmfulness of smoking and most strongly disapproved of smoking. However, experimentation with smoking was found to increase with age, and older children expressed less negative attitudes about smoking. The effects of age were due largely to the differences between the preadolescent groups, on the one hand, and the adolescent group, on the other. In addition, a similar percentage of children in all three age groups perceived strong parental pressure against smoking; however, with increasing age, less opposition from their teachers and friends was perceived. Theories of social influence and moral development are considered in explaining the results.     

Evaluating the Effectiveness of a Group CBT for Parents of ADHD Children

Improvements in parenting skills do not necessarily lead to improvements in child and parent outcomes for children with attention deficit and hyperactivity disorder (ADHD). Cognitive factors such as parental cognitions and parenting self-efficacy may influence such outcomes. Clinical research on the effects of cognitive-behaviour therapy (CBT) on parental cognitions, parenting self-efficacy and mental health in Chinese parents of children with ADHD is lacking. This quasi-experimental study intended to assess the effects of a culturally attuned group CBT treatment on the mental health and quality of life of Chinese parents aged 26–58 years, with children with ADHD in Hong Kong. Participants in the experimental group received group CBT and standard treatment and their counterparts in the control group received standard treatment. Primary outcome variables of mental health and quality of life and process variables including parenting stress, parenting efficacy and dysfunctional attitudes were measured at baseline, post-treatment and 3-month follow-up. Data were analysed using 2?×?3 ANCOVAs, Cohen’s d statistics and multiple mediation analyses. Group by time interactions were found for most outcome variables. Effect size statistics indicated that group CBT had small to moderate effects on most outcome variables at post-treatment and follow-up assessments. The effect of CBT on mental health was mediated by the reduction in parenting stress and the effect of CBT on quality of life was mediated by the reductions in parenting stress and dysfunctional attitudes. Given its potential benefit, it is worth considering incorporating this group CBT programme into interventions for Chinese parents with ADHD children.     

The effects of smoking norms and attitudes on quitting intentions in Malaysia,Thailand and four Western nations: A cross-cultural comparison

This research investigated the influence of smoking attitudes and norms on quitting intentions in two predominantly collectivistic countries (Malaysia and Thailand) and four predominantly individualistic Western countries (Canada, USA, UK and Australia). Data from the International Tobacco Control Project (N = 13,062) revealed that higher odds of intending to quit were associated with negative personal attitudes in Thailand and the Western countries, but not in Malaysia; with norms against smoking from significant others in Malaysia and the Western countries, but not in Thailand; and with societal norms against smoking in all countries. Our findings indicate that normative factors are important determinants of intentions, but they play a different role in different cultural and/or tobacco control contexts. Interventions may be more effective if they are designed with these different patterns of social influence in mind.     

The interplay of received social support and self-regulatory factors in smoking cessation

Objective: In smoking cessation, individual self-regulation and social support have both proven to be useful. However, the roles of self-regulatory processes and social support are mostly examined separately. The present study aims at examining the unique and joint interactive effects of self-regulation as specified in the health action process approach (HAPA) and social support on smoking cessation. The study tested whether social support can compensate for low levels of self-regulation or whether synergistic effects emerge.

Design & Measures: Around a self-set quit date, 99 smokers completed baseline questionnaires on HAPA-variables, smoking-specific received social support and smoking cessation (continuous abstinence and point prevalence), with a follow-up Cpproximately 29?days after the quitdate.

Results: Social support moderated the association between volitional self-efficacy and smoking, as well as coping planning and smoking but not between action planning and smoking. No compensatory effect of social support for lower levels of individual regulation emerged but the combination of high levels of the individual variables and social support was related to successful smoking cessation, indicating a synergistic effect.

Conclusions: The results confirm the importance of examining both self-regulation and social factors in smoking cessation. This should be considered when developing future interventions for smoking cessation.