Smoking is a disastrous challenge to public well-being across the world. It has anticipated the dimension of an epidemic leading to massive disability, sickness, and death (Rigotti, 2013). The use of tobacco and smoking not only causes harm to one’s own health but also leads to many societal costs including reduced efficiency and health maintenance burden, environmental destruction, and poverty.
Wise, Weierbach, Cao, and Phillips (2017) considered the use of tobacco as causing highest number of preventable deaths. Many types of chronic illnesses, pulmonary and cardiovascular diseases are linked with the use of tobacco products.
Families plays a vital role in building one’s personality, whether it be in a positive way or negative one.A family’s capability to deal with everyday life tasks, unexpected disasters, and the typical variations that happen in families over a period of time is directly associated to a family (Peterson, 2009).
Family relationships are assumed to be having three major characteristics i.e. they persist over time, they are emotionally intense, and they involve high levels of intimacy in day-to-day life.
Role of family impacts on many aspects of life. One of the major issue that people are facing is related to smoking and the related illnesses. Research proved that parental nicotine addiction and parental smoking are among the two major factors that are related with smoking in youngsters and teenagers (Moyer, 2013).
Family impact, absence of parental support and incorrect guidance about negative consequences of smoking are amongst the elements that enhance the dangers of smoking initiation. (Moyer, 2013; Pbert, Farber, Horn, et al. (2015); Mutti, Hammond, Reid, &Thraser, 2013).
Theories associated with the role of families in the prevention of smoking related illnesses
Below discussed are some of the theories that are linked to the role of the family in the prevention of smoking related illnesses.
Social Learning theory proposes that individuals learn and acquire through observing others’ conduct, attitudes, and the results of those behaviours. Bandura (1977) emphasized that individual’s behaviour is learned observationally through modelling i.e. observing others’ behaviour. Social learning theory describes individual’s behaviour in terms of constant reciprocal collaboration among environmental, cognitive, and behavioural influences.
When a child is born, he/she starts to imitate whatever he/she sees around him/her and this process continues throughout the life. People tend to copy what they see around them either it be their family members, neighbours, or friends. However family is the starting unit of one’s life and an individual learns most of the things from the family members due to the attachment and closeness of family members.
One of the research claimed that most of the smokers reported that they started smoking because they observed their parents or other family members smoking (Bowman & Bryant, 2011). It can be concluded that an individual tends to smoke by imitating the family members. This process can be reversed i.e. one can overcome the smoking addition or discontinue smoking if the family members do so and provide social support.
A lot of evidence is available and proves that social cognitive theory helps smokers in dealing with smoking and thus reducing smoking related illnesses.Heydari, Dashtgard, &Moghadam (2014)claimed through the research that individuals who got social support from one of their close family member tended to quit smoking as compared to those individuals who did not get any social support and were give conventional treatment. This research also showed that the recurrence rate was significantly low for those individuals who got social support as compared to those who followed conventional treatment methodologies. A significant increase in self-efficacy (an individual’s belief that he/she can do something) was also reported among the individuals who got social support as compared to those who did not get any social support.
The theory of social learning is functional in the field of substance use, demanding that individuals presume optimistic expectancies and attitudes towards substances through the process of observing or imitating positive statements or attitudes of their models (Giovazolias&Themeli, 2014).
The cognitive expectancy theory proposes that an individual will give priority to one behaviour as compared to those of other behaviours and is motivated to behave in that way because they expect the results of their behaviour more favourable.In making such decision, i.e. which behaviour to select, individual’s cognitive processes are involved.
This theory specifically focuses on addictions and can serve as a basis for preventing smoking related illnesses with the help of family members. An individual usually learns to expect certain behaviours by the behaviours of his/her family. If the family members will reward an individual with a positive outcome whenever he/she do something more appropriate, the individual will start to expect the same outcome whenever he/she do something desirable. He/she will develop positive expectations towards those behaviours and choose those behaviours that the family considers desirable over others.
If an individual is involved in smoking or is willing to get involved in smoking that may lead to future associated illnesses, the family members must focus his/her attention towards more negative outcomes of smoking and more positive outcomes of not smoking. This will cause the individual to expect negative results of smoking and positive results of not smoking and leading to choose no smoking over smoking.
Kumpfer (2014) found that parental supervision lead to build certain expectations in children and these expectations in turn are directly associated with drug and substance abuse. If the expected results of smoking are guided by parents as negative, children will not initiate smoking.
John Bowlbypresented this theory and emphasized on the significance of attachment with personal development. He proposed that a strong emotional and physical closeness of a child with a caregiver plays highly important role in the development process of that child.This attachment in turn provides the child with feelings of security and hence increasing the chances to take risks and take adventures (Bowlby, 1969).
Linking up this theory and considering the implications of the above assumed points, it can be concluded that if a person is strongly attached to at least one of his/her family members and get proper guidance about the negative and positive aspects of smoking, he/she will tend to show resistance towards smoking and the smokers will tend to quit smoke hence preventing and reducing smoking related illnesses.
Lack of strong attachment with a parent or other significant caregiver is one of the major risk factor for drug addictions and mental health problems (Stormshak, Connell, Véronneau et al., 2011).
Research evidence shows that a secure attachment with significant caregiver can cause the preventions of smoking initiation and thus reducing smoking related illnesses (Wise, Weierbach, Cao, and Phillips, 2017). Another research proposed that strong attachment among partners can possible improve one’s health practices and help in quitting and preventing smoking (Pietromonaco, Uchino, &Dunkel, 2013).
There are multiple developmental theories that proposes different stages of physical and psychological development characterized by qualitative differences (Erik Erikson‘s stages of psychosocial development, James W. Fowler‘s stages of faith development theory, Sigmund Freud‘s psychosexual stages, Abraham Maslow‘s hierarchy of needs, Jean Piaget‘s theory of cognitive development described how children represent and reason about the world etc.)
Although there are individual differences in development stages among individuals but researchers tend to assume that most people follows a sequence of developmental stages simultaneously.
A child start developmental processes even before the birth and the process continues throughout the life. The first relationship that most of the new-borns enjoy is of parents or other significant family member. If family member guides correctly and maintain healthy relationship with the child, this leads to normal psychological and physical development of child thus reducing the chances of illnesses.
Sussman (2013) found that family involvement is important in all phases of development, and can prevent smoking and the related illnesses. The early the intervention of parents, the successful the results would be in preventing smoking related illnesses.Tobacco and substance abuse prevention plans are personalized as per an individual’s developmental stage.
Families highly influence in preventing smoking behaviours and the associated illnesses. They also help the smokers to quit smoking and leading a healthy lifestyle afterwards with reduced chances of relapse.
Smoking and indirect exposure to smoke are dangerous at all phases of life, initiating before the birth. Many health effects could last for the whole life. Parents and caregivers should be guided about the health issues and techniques to reduce them. For a successful prevention, the emphasis should be on family (Harvey & Chadi, 2016).
Literature suggests that preventing smoking in youngsters and teenagers is greatly influenced by family-focused interventions (Harvey & Chadi, 2016).
Biopsychosocial model is an approach involving social, environmental, physical, and developmental aspects. This would be best for an individual for preventing and quitting smoking. Interventions must also involve multiple individuals i.e. peers, family member, school staff, media, and communities in order to maximize the preventions of smoking and hence preventing smoking related illnesses. Researchers have found early intervention beneficial in directing individuals away from problem behaviours and toward prosocial activities (Sussman, 2013).
Bandura, A. (1977). Social learning theory. New York: General Learning Press.
Bowlby J. (1969). Attachment and loss: Vol. 1. Loss. New York: Basic Books.
Bowman L, Bryant L. (2011). The application of social learning theory to understanding smoking behaviour among LGBTQ individuals. Adult education research conference, 2011.
Giovazolias, T.&Themeli, O. (2014). Social learning conceptualization for substance abuse: Implications for therapeutic interventions. The European journal of counselling psychology, 3(1).
Harvey, J. & Chadi, N. (2016). Preventing smoking in children and adolescents: Recommendations for practice and policy. Canadian paediatric society,21(4).
Kumpfer, K. L. (2014). Family-Based Interventions for the prevention of substance abuse and other impulse control disorders in girls. International scholarly research notices,2014.
Moyer, V. A. (2013). Primary care interventions to prevent tobacco use in children and adolescents: U.S. preventive services task force recommendation statement. Paediatrics,132(3).
Mutti S., Hammond D., Reid J. L., & Thrasher J. F. (2013) The efficacy of cigarette warning labels on health beliefs in the United States and Mexico. Journal of health communication, 18(10).
Pbert, L., Farber, H., Horn, K. et al. (2015). State-of-the-art office-based interventions to eliminate youth tobacco use: The past decade. Pediatrics,135(4).
Peterson, R. (2009). Families first: Keys to successful family functioning family roles. Virginia tech, 350-093.
Pietromonaco, P. R., Uchino, B., &Dunkel, S. C. (2013). Close relationship processes and health: implications of attachment theory for health and disease. Health psychology : official journal of the division of health psychology.American Psychological Association, 32(5).
Rigotti N. A. (2013). Smoking cessation in patients with respiratory disease: Existing treatments and future directions. Lancet Respir Med, 2013.
Stormshak, E. A., Connell, A. M., Véronneau M. H. et al. (2011). An ecological approach to promoting early adolescent mental health and social adaptation: family-centered intervention in public middle schools. Child Development, 82(1).
Wise, M. H., Weierbach, F., Cao, Y., & Phillips, K. (2017). Tobacco use and attachment style in Appalachia.Issues in Mental Health Nursing, 38.