Talking to Kids About Teen Smoking: How to Do It Right
If you know the rules, you can help teens stop smoking
Posted Jun 20, 2011
Newsflash: Kids don't like being preached to - especially when it's done hypocritically
A recent study assessed the impact parents have over the decisions their teenagers make concerning whether or not to 'experiment' with smoking cigarettes and to continue smoking in the long term, once they have tried it.
Experimenting with smoking represents a form of risk-taking for some teens while it can serve as the onset of long-term chronic cigarette smoking for others. Deciding which group a given teenager is a part of during the initial stage of experimentation is difficult, and figuring out whether it is possible to influence the trajectory of future behavior in teens is the focus of this line of research. The researchers theorized that variations in communication between parents and their teenagers might shine some light on these all-important issues.
So the researchers developed the Family Talk about Smoking paradigm, or FTAS, a method of standardizing the interaction and communication between teen smokers and their parents who had either smoked in the past or currently smoke. It's a neat method that allowed them to study parent-teen interactions in a natural setting.
What is the FTAS - Assessing parent-teen communication
The FTAS is a 10-minute, semi-structured family interaction paradigm. It employs using a flip card the parent or teen are asked to read to one another. They take turns and each flip card initiates a conversation 'trigger' designed to stimulate smoking-related conversation. The cards focused on five triggers: a) "How people in our family feel about cigarette smoking," (this is read by the teen), "My experiences with cigarette smoking" (by the parent), "How today's teens make decisions about cigarette smoking," (by the teen with this wording used to break open discussion without forcing teen to expose his own experience unless he wants to), and "What parent do if they find out their teen has become a smoker" (by the parent).
The families were given 10 minutes for each topic and were encouraged to use the entire time. Some families used the full ten minutes for some topics, and used less for others while other families sped through them all without lingering on specifics.
It may seem a little contrived and forced, but steps were taken to allow free-flowing conversations between parents and their teens. The FTAS discussion took place in the home environment in order to make the family more comfortable and there was a warm -up exercise to get everyone talking about their family life. When the time came for the FTAS discussion, the field staff left the room and observed the interaction remotely.
So, let's look at what was measured.
A coding system was used to measure the:
- Level of disapproval the teenager received from the parent
- Just how clearly the parent elaborated on consequences for smoking cigarettes
- Whether the parent conveyed to the teen that he expected she would or wouldn't be a smoker
- The quality of personal disclosure by the parent about his own smoking struggles or non-smoking
The teens and their parents were assessed initially and were then revisited 6 months after the baseline assessment to determine whether the family's communication affected teen smoking 6 months later. It's important to note: 90% of parents involved in the study had had some involvement with smoking at some point in their lives.
The patterns of communication between the teens involved in the study and their parent(s) varied depending on whether the teen (and his parent ) were smokers themselves. The teen's receptivity to his parent's attitude and communication about teenage smoking, and about his/her particular smoking, was directly affected by whether the parent smoked currently, or in the past, and what the parent's attitude about it was as well as how openly the parent opened up to his teen about it.
While the study was a controlled assessment of teen-parent communication about smoking cigarettes, it's important to note its implications for family communication about substance abuse, and other taboo issues. There's no doubt that communication is extremely important when it comes to these topics and that open communication often leads to better outcomes than ignoring or avoiding these issues.
The results - Talking to teens about smoking can help if it's done right
Communication patterns and their effect depended greatly on who the teen was speaking to - with mothers, expressing more positive expectancies about cigarette smoking predicted more persistent smoking while with fathers more disapproval during conversations predicted lower chances of persistent smoking.
The researchers found that non-smoking parents who had frequent and quality communication with their teenager about smoking had a consistently positive effect on reducing the chances that their teen will continue to smoke. However, the results revealed that if the parent smoked their influence through communication was much more complicated. For fathers, past smoking combined with a lot of teen disclosure predicted much greater likelihood of continued smoking - it's the "war story" sort of effect with parent and teen sharing experiences and little disapproval leading to no reduction in experimentation. For currently smoking mothers the important factor was also disclosure but this time by the parent - if the mother shared little about her experiences, the effect on teen smoking was small but if she shared a lot, the odds of persistent teen smoking went way down. When non-smoking mothers talked a lot about the consequences of smoking, the probability of persistent teen smoking went up - kids don't like being preached to.
What does it all mean?
Overall, the study's results suggest that teens are highly suspect of hypocritical preaching and are very much influenced by communication patterns with their parents. Specifically, the study revealed that when a mother was a current smoker, if she communicated openly to her teenager that she had struggles about smoking and the difficulty of quitting, there was a positive effect on the teen's eventual decision to stop. But for former smoking fathers and non-smoking mothers, talking at length about the teen's experiences smoking and about the negative consequences of smoking respectively were not productive and actually increased the probability that the teen would still be smoking six months later.
As the authors note: "... current smoking mothers who are highly disclosing may acknowledge their own struggles around smoking and their difficulty asking their teens to "do what I say not what I do." Openness about this struggle may help adolescents deal with the issue of "mixed messages" when a parent is a smoker. In contrast, the impact of maternal elaboration of rules may be attenuated when mothers have been active smokers because the parents' own behavior is contradictory." Reducing hypocritical messages and communicating openly about these difficult issues seems to be the way to go.
When taking all these findings into account it would seem that passivity on the part of a parent rather than communicating with the teen seems to be received by the teen as a silent approval of smoking. However a parent's open and transparent sharing with his teen about his own regretted decisions, and the difficulty that has resulted, can have a very positive effect on the decisions the teen makes.
The bigger picture
If these things are true with cigarette smoking, would they not also be true regarding experimentation with other substances? Can parents open up about their experiences to their teens, expose their difficulties and vulnerabilities, and give the teen the gift of a loving parent's experience?
Maybe more importantly, when thinking about the right ways to engage in teen-parent communication about difficult issues, a little insight into family dynamics that may have an impact on the discussion seems crucial. I often get questions from parents I know about the most appropriate way to talk to kids about drug use. This research seems to carry the following message - don't preach if you haven't been there and don't be hypocritical if you have - open communication that guides the teen toward the desired behavior without letting them discount the impact of their choices seems the best idea.
Before we go, it's important to note that this study used only a six-month follow-up and that future studies should really examine more long-term effects of family communication patterns in order to increase our confidence in these results. It's possible that family communication can have a long-lasting effect or that it needs to be re-enforced on an ongoing basis. This study doesn't tell us much about that.
Lauren S. Wakschlag, Aaron Metzger, Anne Darfler, Joyce Ho, Robin Mermelstein, and Paul J. Rathouz (2010). The Family Talk About Smoking (FTAS) Paradigm: New Directions for Assessing Parent-Teen Communications About Smoking. Nicotine and Tobacco Research.
© 2011 Adi Jaffe, All Rights Reserved
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