Parental smoking and children's anxieties: an appropriate strategy for health education?

Abstract

While the prevalence of smoking has declined in the UK in recent years, class differentials in smoking behaviour have become more marked and smoking is increasingly recognised as a causal factor in inequalities in health. Health education initiatives to support both smoking cessation and to teach children about the health risks of smoking remain key initiatives in reducing health inequalities. However, teaching children about the risks of smoking and the impact of parental smoking on their health is not straightforward for children from backgrounds who are more likely to encounter smoking at home and in their local communities. These children have to reconcile the key messages taught at school and reinforced in smoking cessation campaigns with the knowledge that their parents and other family members smoke. In this article we consider how children from smoking homes make sense of these education and health campaigns as observed by their parents, and the impact that this has on both parental smoking and relationships within the home. The article thus seeks to challenge assumptions about the delivery of health education and the need to acknowledge family diversity.

Keywords:

• parental smoking
• health education
• home
• children's health
• health inequalities

Acknowledgements

This study was funded by a small grant from the Wellcome VIP award to the University of Liverpool. We thank our respondents for given so generously of their time in taking part in the research, Bethan Evans and the two anonymous referees for their comments on the original draft. All names and personal details of respondents have been changed.

Notes

Legislation prohibiting smoking in workplaces and enclosed public places was introduced in England in July 2007 (Bauld 2011).

Personal, Social, Health and Citizenship education (PSHCE) has been a non-statutory part of the national curriculum in England for primary and secondary schools. In 2010 the Labour Government introduced a proposal, to be introduced from 2011, to include a statutory requirement for children to ‘learn about staying safe and how to handle risks relating to issues including harmful relationships, drugs and alcohol, and how and where to get help’ (Qualification and Curriculum Development Agency, n.d.). These proposals were dropped by the Coalition Government in May 2010 and the teaching of PSHCE remains non-statutory. The 2010 Schools White Paper reiterated the government's commitment to PSHCE but proposed an internal review on how it should be delivered (Department of Education 2010).

Achieving smoke-free school status does not just refer to banning smoking in school grounds but also informs education and, where appropriate, the promotion of smoking cessation treatments. The accreditation is usually awarded as part of the National Healthy Schools Programme (Ofsted 2006). However, this does not mean that young people do not create their own ‘smoking spaces’ within the schools.

Fag ends is a community-based stop smoking service based in Liverpool that provides support for smokers wanting to quit.