The purpose of this study was to understand parental approach to the topic of smoking with school-age preadolescent children. In-depth interviews were conducted with 38 parents and yielded a grounded theory that explains how parents communicated with their children about smoking. Parents perceived smoking to be a latent danger for their children. To deter smoking from occurring they verbally interacted with their children on the topic and took action by having a no-smoking rule. There were three interaction approaches, which differed by style and method of interaction. Most parents interacted by discussing smoking with their children. They intentionally took advantage of opportunities. Some interacted by telling their children about the health effects of smoking and their opposition to it. They responded on the spur-of-the-moment if their attention was drawn to the issue by external cues. A few interacted by acknowledging to their children the negative effects of smoking. They responded only when their children brought it up. The parents’ intent for the no-smoking rule, which pertained mainly to their homes and vehicles, was to protect their children from second-hand smoke and limit exposure to smoking. The theory can be used by nurses to guide interventions with parents about youth smoking prevention. 1. Introduction Tobacco use continues to be the leading cause of preventable morbidity and mortality in many countries and has been described as a global epidemic [1]. Smoking is most commonly tried and established in adolescence [2]. Tobacco dependence typically occurs in the early years of use, even at low levels of smoking [3, 4] and is considered a childhood condition [1]. Early age of smoking initiation is associated with heavy smoking over time [2]. Further, smoking during youth is associated with subsequent alcohol and illicit drug use during youth and for that reason it has been referred to as the gateway drug. The developing brain may be particularly susceptible to addiction, which makes primary prevention of smoking in youth all the more important [2, 5]. Despite a decline in some countries in recent years, youth smoking remains a major public health concern in many countries world-wide [6]. Within Canada cigarette smoking among adolescents aged 15 to 19 is at 14% [7]. Among younger children, ages 11 to 14 years, 22% have at least tried a cigarette [8]. Typically, smoking rates are based on cigarette use. Unfortunately, that tells only part of the story as many youths world-wide smoke other forms of tobacco, for example, little cigars and pipes
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