How do I know if my child will become a smoker?

Studies demonstrate that the two most important predictors determining your child's risk of becoming a smoker are access to cigarettes and friends who smoke. The following is a quiz to assess the risk of your child becoming a smoker.

Does your child hang around with other kids who smoke cigarettes?

The smoking rate among kids who have three or more friends who smoke is 10 times higher than the rate among kids whose friends are smoke-free.

Do you or your spouse smoke ?

Studies have shown that kids whose parents are smokers are at least twice as likely to smoke.

Do your child's siblings smoke?

Having an older brother or sister who smokes triples the odds that a younger sibling will smoke.

Is your child having trouble in school?

Smoking is linked to poor academic achievement.

Does your child have a lot of unsupervised time after school? Children who engage in structured after-school programs, such as clubs or sports, have a lower risk of smoking. Be involved in what your children are doing, and know the children and families with whom your children are involved.

Is your child depressed?

Several studies have linked cigarette smoking with symptoms of depression among adolescents.

Is your child an adolescent?

Children ages 11 to 15 in grades 6 to 10 are most vulnerable to peer influences and are most likely to try their first cigarette. If a friend or relative has died from a tobacco-related illness, talk to your teenage son or daughter about this person's death.

Should I enroll my child in a prevention program?

School-based programs will support your conversations with your child about smoking, thus reinforcing the no smoking rule in your household. If your school does not have a tobacco prevention program, find a program for your child in your local area. Then suggest through the Parent Teachers Association (PTA) that your school develop one. The information found in these questions should give you ideas about designing a program for your school and community. Not only will your child benefit from attending a prevention program, but if you are smoker, you will benefit, too.

My spouse is a heavy smoker who refuses to get help to quit. What should I do?

There is not much you can do until he or she is ready to quit. Many smokers have tried to quit but have not been successful. Consequently, they have "given up." Others remember the discomforts of the withdrawal symptoms and would rather not have to go through that experience again. Other people freely admit that they love to smoke and do not want to give it up. Different personalities and different experiences contribute to different attitudes toward smoking.

Many smokers do not realize that new ways are available to assist smokers to quit, which may decrease the negative experiences of withdrawal. If the smoker is willing to think about the possibility of quitting, a spouse can help by collecting information about smoking cessation programs and provide his or her loved one with information about the opportunities for quitting.

A "Change Model," or the "Trans-Theoretical Model" is a process model that identifies stages that a smoker must traverse in order to achieve abstinence. The stages are:

Pre-contemplation: The person is aware that he or she has a problem but has not seriously thought about making a change.

Contemplation: The person begins to see that the behavior is a problem and seriously considers making a change but remains ambivalent about doing so.

Preparation: The person has decided to make a change and has a specific plan to do so in the near future.

Action: The person implements an action plan and begins to make the desired changes.

Maintenance: The person has made the desired change and works to avoid relapsing into the original behavior (smoking).

Termination: The person is safely through the process, experiences zero temptation, and has the ability to resist any temptation 100% of the time.

If a spouse understands these phases, he or she can help a loved one along the pathway to abstinence. During the pre- contemplation and contemplation stages, if the loved one is open to discussion, the spouse can provide information, and also they can talk about a future plan to quit and what the spouse can do to help the smoker quit. Together they can identify a "quit" date. The spouse can provide empathy and support during the next two phases, preparation and action. The nonsmoker spouse may have to overlook the irritability that the smoker is feeling that may lead to some negative behaviors. The "blues" also may contribute to behavior changes. The negatives should be ignored and the positives should be supported. The spouse can help with the maintenance phase by ensuring that the couple's social life takes place only in smoke-free environments and that they socialize solely with nonsmokers. The spouse should constantly offer support during the maintenance and termination stages as well as throughout the withdrawal process. A supportive, loving relationship can go a long way to helping the smoker along the path to a healthy lifestyle.

Joseph's comment:

For many years, I dabbled in trying to quit here and there with little success. Even with the physical ramifications of smoking starting to affect my body, I seemed to have no success. No matter how many people tried to help and encourage me from the outside, I truly don't think I could get on the journey to quitting until I hit my own personal bottom. I tried "smoking cessations" once before, with no luck. Like the old saying goes, "If at first you don't succeed, try, try, again." My second time around, when it came up to the quit date, I put the cigarette down, using the "patch" as an aid, and made it through the first 24 hours. I was so filled with hope that I tried for another day and succeeded. At that point, I felt I was in a "zone." I stopped looking at it as quitting forever and just not smoking one day at a time.

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