Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action
Parents can do much to discourage their children from taking up smoking. Governments can do much to assist parents’ endeavours.
Families
Young teenagers with one or more parents who smoke are more than three times more likely to experiment with smoking. Older teenagers are almost three times more likely to smoke regularly than the teenagers of parents who do not smoke.[187]
Analysis of New Zealand data in 2007 compared with 2001 has shown that the decline in smoking prevalence in teenagers has been greatest for students with no parents smoking, and least for students with both parents smoking (Table 7b of the NZ report).[188] An Australian longitudinal study shows that children of non-smokers are also more likely to remain non-smokers in the long term.[20]
Quitting by parents has a very strong effect on subsequent smoking by children, and is probably the single most important thing that a smoker-parent can do to prevent their children from also becoming smokers.[189]
Smoking by children is also highly related to sibling smoking, and older teenagers often state that they hope their younger siblings do not experiment with smoking; siblings may be an untapped resource for tobacco control.[190, 191]
Smoke-free homes increase adults’ chances of quitting,[192] and reduce the likelihood of children taking up smoking.[193-195] US studies[196, 197] have found that even after controlling for demographic factors and parents’ smoking status, children who lived in homes where smoking was banned were more than 20% less likely to take up smoking than children who lived in homes where smoking was allowed.
Children who spend more time with their families and deal effectively with conflict are less likely to take up smoking: eating dinner together most nights really does seem to be a very good idea![21] Lack of parental supervision is also strongly associated with smoking experimentation.[187]
Action 9.1
Convey the message that parents can help – by quitting smoking; by making their homes smoke-free; by choosing appropriate films, videos and games; and by making it clear that they do not want their children to smoke for the sake of their health.
Schools, universities and other educational institutions
Drug education appears to have limited efficacy in reducing uptake of smoking; however, issues surrounding tobacco – tobacco marketing, the medical aspects of tobacco use, and the public health, legal, social and environmental aspects of tobacco marketing and tobacco control – are very topical and important, and it is useful for young citizens to be informed. Thinking about the health and social justice aspects of tobacco is likely to discourage some young people from using the product.
Smoke-free policies in educational institutions provide a clear message that Australia is working towards a smoke-free future. Properly enforced, smoke-free policies in schools have been associated with lower uptake of smoking in children. They send a clear message that smoking is dangerous for everybody, and can also help to reduce peer pressure to experiment with smoking.
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Action 9.2
Cover the medical, social, environmental and economic aspects of tobacco in the school curriculum and where appropriate in curriculum in tertiary institutions.
Action 9.3
Encourage schools to promote and consistently enforce smoke-free policies (buildings and school grounds) for all members of the school community.
Action 9.4
Encourage universities and other institutes of higher education to adopt smoke-free campuses, including outdoors.
Media
Smoking is portrayed in movies to a much greater extent than it occurs in real life.[198-207] Reviews of the evidence by several scientific bodies[208-210] and several well-designed studies and meta-analyses[211-215] conclude that smoking by popular characters can exert a powerful influence on teenagers, particularly those with temperaments that make them prone to seeking novelty and excitement.[216, 217]
Tobacco-control experts in different countries differ as to the best approach to this problem.[218-220] Bans or automatic ratings for products depicting smoking are strongly opposed by the film and television industries, and would also not be supported by most public health advocates in Australia. One study has shown that the screening of anti-smoking advertisements before films depicting smoking would reduce the impact of such depictions,[221] but advocates fear that such advertisements would quickly become counterproductive unless they had high production values and were frequently replaced. Providing them would be expensive and labour intensive.
Australia should follow the lead of the United States and the United Kingdom, and require the Classification Board to take smoking into account when rating films and video games. Such a move would be consistent with broader government policy on censorship and classification. It may result in fewer damaging depictions of smoking in films seen by younger teenagers. For this measure to be effective, parents would need to ensure that their children only watch age-appropriate films.
Action 9.5
Make smoking a ‘classifiable element’ in movies and video games.