Smoking prevention: Can parents influence whether or not their children become smokers?

Whether or not a young person will take up smoking depends on their own attitudes and the influence of others, parents included. Parents' support and encouragement not to smoke may reduce the likelihood that a young person becomes a smoker.

It is very hard to quit smoking once you are addicted. So the best way to prevent smoking-related illness is to prevent people from starting to smoke in the first place. This mainly concerns young people. Most smokers have started smoking by the time they are 18 years old - perhaps as many as 9 out of 10. The World Health Organization found that over 20% of young girls in Europe are regular smokers by the time they are 15 years old.

Research has shown several major influences on whether young people start smoking. Some of these relate to the individual young person. A young person with major worries about their weight and figure, for example, might be more likely to start smoking to try to be thinner. Young people who do a lot of sports are less likely to smoke. Another factor that influences people's attitudes and behaviour are the attitudes and smoking behaviour of the people around them. Children who start smoking often have friends, brothers, sisters and parents who are smokers too. The younger someone is when they start smoking, the harder it might be for them to quit later.

Researchers have shown that it is not just friends and peers who influence whether or not young people take up smoking: their family is probably one of the main influences. Many people think that parents disapproving of smoking might even encourage their children to rebel and take up smoking. The research suggests otherwise. While it is of course possible that parental disapproval encourages some young people to rebel, in general, non-smokers are more likely to have had parents who disapproved of smoking, who never smoked themselves, or who had quit smoking.

Researchers from the Cochrane Collaboration looked for trials that could show whether there were ways to help parents reduce the chances that their children will start smoking. They found 20 randomised controlled trials that tested whether family intervention was effective at reducing smoking in young people. There were such problems with the way that some of these were done, that they cannot provide very reliable answers. However, some of the trials were able to show that family members can prevent young people from smoking.

The trials looked at lots of different strategies, which means that there is not a lot of evidence about any one strategy. Some of them tested classes for parents, for example, while others just involved sending advice booklets about how to discourage young people from smoking. There was not enough evidence to be able to be sure about what approaches are likely to work. For example, whether having anti-smoking information around the house could really help prevent smoking. Another strategy tested, but not tested enough, was encouraging parents to try to teach their children to be strong and confident about saying "no".

The research did not provide answers about what strategies could have a negative effect. There was no information, for example, on whether some strategies might backfire and then even encourage experimentation or long-term smoking. Or whether other strategies might cause conflicts in the family or make parents feel guilty or anxious.

What the researchers could say was that, in general, when parents are encouraged to be more active about smoking prevention and are given support, their children may be less likely to start smoking. However, at the same time, what the parents do is not the only factor influencing whether or not a young person will become a smoker.

Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care)