Perspectives on smoking of Liverpool primary schoolchildren in their early years
There is a dearth of smoking research involving young children despite the knowledge that the developmental proocess begins in early childhood. This paucity hinders the development of effective smoking prevention strategies, which need to be based on an accurate understanding of the perspectives of the target group. Therefore basic research is required, to discover where primary school children are at in their thinking about smoking before any potent anti-smoking initiatives can be devised. Such an endeavour however, is exacerbated by the lack of appropriate methods of data collection for this particular age group. The aim of this research study was to explore the perspectives that Liverpool primary schoolchildren in their early years (four to eight years of age) have about smoking by examining the beliefs, knowledge, perceptions and behavioural intentions that inform their attitudes about the habit and subsequently, to assess any changes in these factors over time. This work not only provides the understanding and insight fumdamental to the development of proactive health promotion programmes aimed at tackling the increasing prevalence of smoking among local children but also the empirical evidence needed to fill the significant gap in the existing literature on smoking as well. To achieve these aims ,a multi-method, child-centred participatory approach was used. This between-methods traingulation included questionnaires The Draw and Write Technique, semi-structured interviews and focus group interviews. For the cross-sectional study, a representative sample of primary schoolchildren in their early years from wards of varying socio-economic status participated. All were involved in the quantitative method and a subsample partook in the qualitative methods. For the longitudinal study, the same research design was used to track one birth cohort - the children from Reception for a period of three years to document any changes in perspective over time. The research findings from both studies demonstrated that the children in this investigation had considerable understanding about the nature of tobacco smoke, had as yet to take up the habit and generally expressed little intention to smoke in the future. Their perspectives were predominantly negative, very stable and relatively homogenous. They were grounded in a broad knowledge base that was primarily influenced by cognitive development and socio-cultural experiences. They acknowledged the importance of the family and perceived parents to be both preventers and promoters of the habit. The children also harboured some misconceptions, believing that the health implications from smoking were far greater for children than adults. This belief has cultivated a widespread notion that smoking is an intrinsic part of adulthood. The study findings have substantive implications for the development of proactive smoking interventions in primary schools. The results suggest that any prevention strategy devised must be implemented as early as possible in the school curriculum, that it should be developmental in nature and more than knowledge- based. A grass roots approach, one that fosters empowerment tbrough the active involvement of the children in both the development and implementation of the strategy, in collaboration with the school, the home and the community is recommended, as this work has confirmed that children in their early years can be reliable and valid participants in the research process.