Short-Term Effects of a Home-Based Smoking Prevention Program on Antismoking Socialization and Smoking-Related Cognitions: A Cluster Randomized Controlled Trial

Objective: This study aims to evaluate the short-term effects of a home-based smoking prevention program called 'Smoke-free Kids' on antismoking socialization and smoking-related cognitions and the moderating role of parental smoking. Participants and Methods: A cluster randomized controlled trial was carried out using one intervention condition compared with a control condition. A total of 1,398 never-smoking children (mean age 10.11 years, SD 0.78) participated. Intention-to-treat and completers-only analyses were performed. Participants in the intervention condition (n = 728) received 5 activity modules by mail at 4-week intervals. Modules included communication sheets for their mothers. Participants in the control condition (n = 750) received a fact-based intervention only. The main outcomes were the frequency and quality of communication, nonsmoking agreement, house rules, availability of cigarettes, perceived maternal influence, anticipated maternal reactions, attitude, self-efficacy and social norms. Results: Significant effects of the program were found for frequency of communication (B = 0.11, p <0.001), nonsmoking agreement (B = 0.07, p <0.01), perceived maternal influences (B = 0.09, p <0.05), self-efficacy (B = -0.09, p <0.05) and social norms of friends (B = -0.08, p = 0.05) and best friends (B = -0.11, p <0.05). Parental smoking had no moderating effect. Conclusions: The Smoke-free Kids program shows promising short-term effects on antismoking socialization and cognitions. Long-term follow-up on the effects of smoking behavior are needed.