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:
I~£~~0Amercian Academy of Child and Adolescent Psychiary(1997). Illionsis Kane country health department tobacco program. http://www.kaehealth.comlPDFs/Children-Smoking.pdf
Andersen, M.R., Leorux, B. G., Marek, P. M., Peterson,A.V., Kealey,H. A.,Bricker,1. & Sarason,I.G. (2002). Mothers' attitudes and concerns about their children smoking: Do they influence kids? Preventive Medicine,
59-34, 198-206.
Carla,L.S., Nicholas, S. 1., Sheppard, G.K. & James,C. A.(2002). A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking. Durg and Alcohol Dependence, 66, 51-60.
Canadian Paediatric Society. (2001).Smoking and your child: What parents should know. Paediatric Child Health. 6(2),96-97.
Clark, P.I., Scarisbrick-Hauser, A.,Gautam, S. P. & Wirle, S. J.(1999). Anti-tobacco socialization in homes of African-American and white parents, and smoking and nonsmoking parents. Journal ofAdolescent Health, 24, 329-339.
Chen,H. S., Melanie, S. P. & Sharon, D. H. (2001). Cigarettes: A growing problem for Taiwanese adolescents.
Journal ofCommunity Health Nursing, 18(3), 167-175.
Fearnow, M., Chassin, L. & Presson, C. C. (1998). Determinatns of parental attempts to deter their children's cigarette smoking. Journal ofApplied Developmental Psychology, 19(3),453-468.
Fleming, C. B., Kim, H., Harachi, T. W.& Catalano, R. F. (2002). Family process for children in early elementary school as predictors for children in early elementary school as predictors of smoking initiation. Journal of
Adolescent Health,30, 184-189.
Griesbach, D., Amos,A. & Currie, C. (2003). Adolescent smoking and family structure in Europe. Social Science
and Medicine,56(1),41-52.
Heins, M. (1989). Parentips. http://www.parentkidsright.comlParenTips.html.
Ian, S. & Paul, W. (1998). Patterns of alcohol, cigarette and illicit drug use in English adolescents. Adolescent
Substance Abuse,93(8), 1199-1208.
Jackson, C. & Hensiksen,L.(1997). Do as I say: Parent smoking, antismoking socialization, and smoking onset among children. Addictive Behavior, 22(1), 107-114.
Khuder, S. A. Dayal, H. H. & Mutgi, A. B. (1999). Age at smoking onset and its effect on smoking cessation.
Addictive Behaviors,24(5), 673-677.
Kim, Y. H. (2004). Psychological constructs to predicting behavior among Korean secondary school students.
Preventive Medicine,38, 620-627.
Komro, K. A., McCarty, M. C., Forster, J. L., Blaine, T. M. & Chen, V. (2003). Parental, family, and home characteristics associated with cigarette smoking among adolescents. American Journal of Health Promotion, 17(5),291-299.
Litrownik, A. J., Elder, J.P., Campbell, N. R., Ayala, G. X., Slymen, D. J., Parra-Medina, D., Zavala, F. B. &
Lovato, C. Y. (2000). Evaluation of a tobacco and alcohol use prevention program for Hispanic migrant adolescents: Promoting the protective factor of parent-child communication. Preventive Medicine, 31, 124-133.
Medical College of Wisconsin (1999). Health link what you can do to prevent teen smoking. http://healthlink.mcw.edu/article/916868831.html.
Relationship of personal tobacco-raising, parental smoking, and other factors to tobacco use among adolescents living in tobacco-producing region. Addictive Behaviors, 21(3), 349-361.
O'loughlin, J.,Renaud, L., Paraids, G., Meshefedjian, G. & Zhou, X. (1998). Prevalence and correlates of early smoking among elementary school children in multiethnic, low-income inner-city neighborhoods. Annals of
Epidemiology,8, 308-318.
OIds, R. S. & Thombs, D. L. (2001). The relationship of adolescent perceptions of peer norms and parent involvement to cigarette and alcohol use. Journal ofSchool Health, 71(6), 223-228.
Susan, T. E., Karl, E. B., Michael, P., Vangie, A. F., Ying-Chin, C., Tonya, S. K. & Gary, G. K. (2001). Medication in a family-directed program for prevention of adolescent tobacco and alcohol use. Preventive
Medicine, 33, 333-346.
U. S. Centers for Disease Control (2003). Tobacco information and prevention source. http://www.cdc.gov/tobacco/ educationalmaterials/yuthfax l.html #Parents.
U. S. Centers for Disease Control (2004). Cigarette use among high school students-United States 1991-2003: Smoking continues to fall among US teens. Morbidity and Mortality Report, 53(23), 499-502.
Xiaoming,L., Xiaoyi, F.& Bonita, S. (1999). Cigarette smoking among schoolboys in Beijing, China. Journal of
Adolescence,22, 621-625.
93/09/24 f9:~
93/12/30 ~Ql[
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61-Parental prevention strategy and adolescent's
smoking knowledge, attitude and behavior
Hsiang-Ru Lai
Kuo-Hsin Chao
Der-Min Wu
Shih-Yang Chiu
Chung-Yi Chun
Hsin-Yi Lee
Abstract
Pi-Hsia Lee
Tzu-Yu Liu
Parents are good gatekeepers to prevent adolescents from smoking. This study aims to assess parental prevention strategy and the relationship between parental practices and child's smoking knowledge, attitude and behavior.
By using random sampling, 36 classes of six high schools in Yilan County were chosen. Students in these classes and their parents finished one self-administered questionnaire separately. Totally, 1175 pairs of parent-child provided valid information. Multiple regression and logistic regression statistics were used as main analysis method.
The results showed that adolescent's knowledge of tobacco hazard was above 70% and they had positive anti-smoking attitudes. The lifetime smoking prevalence rate of the adolescent subjects was 19.0%. Parents did the preventing strategy occasionally. Parents did better in controlling child's pocket money, listening and rearing children but did poor in sharing parenting experience with others. Parental prevention strategy was associated with child's smoking-related attitudes and behavior. With better parental practice, adolescents' anti-smoking attitudes were more positive and were less likely to be smokers. However, parental prevention strategy was not related to adolescent's knowledge of tobacco hazard.
The findings suggest that parental education is needed to improve parents' prevention practice in order to reduce adolescents' smoking rate.
Key words:Parental prevention strategy, adolescents, knowledge of tobacco hazard, anti-smoking attitudes, smoking behavior