Abstract
BackgroundRole conflict can motivate behavior change. No prior studies have explored the association between parent/smoker role conflict and readiness to quit. The objective of the study is to assess the association of a measure of parent/smoker role conflict with other parent and child characteristics and to test the hypothesis that parent/smoker role conflict is associated with a parent’s intention to quit smoking in the next 30 days. As part of a cluster randomized controlled trial to address parental smoking (Clinical Effort Against Secondhand Smoke Exposure—CEASE), research assistants completed exit interviews with 1980 parents whose children had been seen in 20 Pediatric Research in Office Settings (PROS) practices and asked a novel identity-conflict question about “how strongly you agree or disagree” with the statement, “My being a smoker gets in the way of my being a parent.” Response choices were dichotomized as “Strongly Agree” or “Agree” versus “Disagree” or “Strongly Disagree” for the analysis. Parents were also asked whether they were “seriously planning to quit smoking in 30 days.” Chi-square and logistic regression were performed to assess the association between role conflict and other parent/children characteristics. A similar strategy was used to determine whether role conflict was independently associated with intention to quit in the next 30 days.MethodsAs part of a RTC in 20 pediatric practices, exit interviews were held with smoking parents after their child’s exam. Parents who smoked were asked questions about smoking behavior, smoke-free home and car rules, and role conflict. Role conflict was assessed with the question, “Please tell me how strongly you agree or disagree with the statement: ‘My being a smoker gets in the way of my being a parent.’ (Answer choices were: “Strongly agree, Agree, Disagree, Strongly Disagree.”)ResultsOf 1980 eligible smokers identified, 1935 (97%) responded to the role-conflict question, and of those, 563 (29%) reported experiencing conflict. Factors that were significantly associated with parent/smoker role conflict in the multivariable model included: being non-Hispanic white, allowing home smoking, the child being seen that day for a sick visit, parents receiving any assistance for their smoking, and planning to quit in the next 30 days. In a separate multivariable logistic regression model, parent/smoker role conflict was independently associated with intention to quit in the next 30 days [AOR 2.25 (95% CI 1.80-2.18)].ConclusionThis study demonstrated an association between parent/smoker role conflict and readiness to quit. Interventions that increase parent/smoker role conflict might act to increase readiness to quit among parents who smoke.Trial registrationClinical trial registration number: NCT00664261.
Highlights
Twenty practices were recruited from Pediatric Research in Office Settings (PROS), the practice-based research network of the American Academy of Pediatrics
The data for this analysis was collected as part of a larger study testing a pediatricoffice based tobacco control program for families called CEASE (Clinical Effort Against Secondhand Smoke Exposure)
In a separate multivariate logistic model, parent/ smoker role conflict was independently associated with intention to quit in the 30 days [Adjusted Odds Ratio (aOR) 2.25] (Table 3)
Summary
No prior studies have explored the association between parent/smoker role conflict and readiness to quit. Parental smoking is associated with parental morbidity and mortality, increased risk of house fires, diversion of income, and greater likelihood of children’s tobacco addiction [5]. In these ways, smoking cigarettes attenuates parents’ performance of the protective function that is a defining characteristic of the parental role [6]. The child health care setting provides unique teachable moments to motivate parents to quit smoking as a result of the number of contacts a parent has with his or her child’s healthcare provider and the strong link between TSE and chronic and acute childhood illness [5,7,8,9]. For parents who lack a primary care provider, their child’s doctor may be a key access point for pharmacological advice and treatment for tobacco addiction [10,11]
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