CIGARETTES, ALCOHOL ON TODDLERS' SHOPPING LIST
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《肿瘤学学报》
Children as young as age 2 years are more aware of cigarettes and alcohol than commonly believed, Dartmouth researchers reported recently in the Archives of Pediatrics and Adolescent Medicine (2005;159:854–859). In a role-playing study involving dolls and a toy grocery store, 28.3% of children aged 2 to 6 years bought cigarettes, and 61.7% bought alcohol in preparation for a make-believe evening with friends.
What’s more, their play indicates that many young children have a well-developed notion of how and why adults use these products in social settings. For instance, some children in the study immediately offered their doll guests alcoholic drinks after returning with their purchases, or passed around cigarettes after their pretend meal.
The findings suggest tobacco prevention and other healthy lifestyle messages may need to be initiated at much younger ages than is currently the norm, said lead study author Madeline Dalton, PhD, Associate Professor of Pediatrics at Dartmouth Medical School and Director of the Hood Center for Children and Families at Dartmouth. And the messages need to come from both parents and physicians.
"Parents typically think children are too young to talk about alcohol or tobacco when they’re 2 and 3 years old, but this study shows that they’re already learning about it and getting powerful messages," she said. "As health care professionals and researchers, we typically wait until children are adolescents to start giving our prevention messages, but I think it’s difficult to talk to a child or adolescent about why they shouldn’t smoke if they’ve already believed for 10 years that smoking is an integral part of socializing."
The research involved 120 children between the ages of 2 and 6 years and their parents, who were surveyed about their own smoking and drinking habits. Dalton and her colleagues observed the children making purchases in a toy supermarket stocked with mini versions of 133 items typically found in stores, including fruits, vegetables, meat, dairy, breads, cereal and prepared foods, snacks, candy, toiletries, medicine, and nonalcoholic beverages. The inventory also included cigarettes (branded Marlboro and Camel), beer (branded Budweiser, Coors, Schlitz, and Pabst), and wine.
The children were asked to identify each purchase at the checkout counter. Cigarette and alcohol purchases were measured only if the child correctly identified the product or bought it even after being told by the researcher what it was. Purchases were not counted if a child misidentified the item after being told what it was (referring to beer as soda, for instance).
Children whose parents smoked were nearly four times more likely to purchase cigarettes than children of nonsmokers (odds ratio [OR] 3.90, 95% confidence interval 1.20 to 12.63). And children whose parents drank alcohol at least once a month were significantly more likely to buy alcohol than children whose parents drank less often (OR 3.04, 95% confidence interval 1.02 to 9.10). But the children of smokers and drinkers were not the only children buying cigarettes and alcohol.
"We asked about parental tobacco and alcohol use because at that age parents tend to be the primary role models for children, but I think [the results] are indicative of all adult behavior that children are exposed to," said Dalton, who is also a researcher at Dartmouth’s Norris Cotton Cancer Center.
Of the 34 children (28.3%) who bought cigarettes, half correctly identified them as such, and six (17.7%) were able to name them by brand. Of the 74 children (61.7%) who bought alcohol, 43 (58.1%) were able to identify it as beer, wine, or "booze," although the researchers did not note the same level of brand awareness for alcohol as for cigarettes. Twenty-nine children (24%) purchased both cigarettes and alcohol.
Dalton said her team was surprised by those numbers.
"At age 2 to 6, we didn’t expect such a high percentage of children would be tuned into these products and didn’t expect them to think they would be necessary for a social evening," she said. "I hope it prompts people to question whether we should be waiting until adolescence to intervene."
Comments the children made while playing show just how "tuned in" they really are—to messages both positive and negative.
One 6-year-old boy, offering a Barbie doll a newspaper and cigarettes, said, "Honey, have some smokes. Do you like smokes? I like smokes."
Choosing a pack of Camels in the store, a 4-year-old girl said, "I need this for my man. A man needs cigarettes."
A 6-year-old boy pointed to cigarettes in the store and said, "I’m definitely not going to buy those; they can kill you."
It is well-known that children of parents who smoke or drink alcohol are more likely to adopt those habits themselves, Dalton said. "This study provides a little insight into why that might be," she explained. "Children are developing these perceptions really early in life and they’re unquestioned beliefs that they carry through to later in life."
The message for parents in all this is clear, said Dalton, who has children herself.
"It’s really important to be mindful of your behavior and the messages your behavior is sending your children," she said. "Parents shouldn’t smoke at all, but if they do, they shouldn’t smoke around their children. It’s bad for their own health and their children’s health, and it’s also bad modeling behavior."
The message for alcohol is a bit more complicated, she noted, because moderate drinking is not harmful and may actually have health benefits. However, parents can make sure that alcohol isn’t the focus of socialization or coping. "It’s important to provide that balance," she said.
What’s more, their play indicates that many young children have a well-developed notion of how and why adults use these products in social settings. For instance, some children in the study immediately offered their doll guests alcoholic drinks after returning with their purchases, or passed around cigarettes after their pretend meal.
The findings suggest tobacco prevention and other healthy lifestyle messages may need to be initiated at much younger ages than is currently the norm, said lead study author Madeline Dalton, PhD, Associate Professor of Pediatrics at Dartmouth Medical School and Director of the Hood Center for Children and Families at Dartmouth. And the messages need to come from both parents and physicians.
"Parents typically think children are too young to talk about alcohol or tobacco when they’re 2 and 3 years old, but this study shows that they’re already learning about it and getting powerful messages," she said. "As health care professionals and researchers, we typically wait until children are adolescents to start giving our prevention messages, but I think it’s difficult to talk to a child or adolescent about why they shouldn’t smoke if they’ve already believed for 10 years that smoking is an integral part of socializing."
The research involved 120 children between the ages of 2 and 6 years and their parents, who were surveyed about their own smoking and drinking habits. Dalton and her colleagues observed the children making purchases in a toy supermarket stocked with mini versions of 133 items typically found in stores, including fruits, vegetables, meat, dairy, breads, cereal and prepared foods, snacks, candy, toiletries, medicine, and nonalcoholic beverages. The inventory also included cigarettes (branded Marlboro and Camel), beer (branded Budweiser, Coors, Schlitz, and Pabst), and wine.
The children were asked to identify each purchase at the checkout counter. Cigarette and alcohol purchases were measured only if the child correctly identified the product or bought it even after being told by the researcher what it was. Purchases were not counted if a child misidentified the item after being told what it was (referring to beer as soda, for instance).
Children whose parents smoked were nearly four times more likely to purchase cigarettes than children of nonsmokers (odds ratio [OR] 3.90, 95% confidence interval 1.20 to 12.63). And children whose parents drank alcohol at least once a month were significantly more likely to buy alcohol than children whose parents drank less often (OR 3.04, 95% confidence interval 1.02 to 9.10). But the children of smokers and drinkers were not the only children buying cigarettes and alcohol.
"We asked about parental tobacco and alcohol use because at that age parents tend to be the primary role models for children, but I think [the results] are indicative of all adult behavior that children are exposed to," said Dalton, who is also a researcher at Dartmouth’s Norris Cotton Cancer Center.
Of the 34 children (28.3%) who bought cigarettes, half correctly identified them as such, and six (17.7%) were able to name them by brand. Of the 74 children (61.7%) who bought alcohol, 43 (58.1%) were able to identify it as beer, wine, or "booze," although the researchers did not note the same level of brand awareness for alcohol as for cigarettes. Twenty-nine children (24%) purchased both cigarettes and alcohol.
Dalton said her team was surprised by those numbers.
"At age 2 to 6, we didn’t expect such a high percentage of children would be tuned into these products and didn’t expect them to think they would be necessary for a social evening," she said. "I hope it prompts people to question whether we should be waiting until adolescence to intervene."
Comments the children made while playing show just how "tuned in" they really are—to messages both positive and negative.
One 6-year-old boy, offering a Barbie doll a newspaper and cigarettes, said, "Honey, have some smokes. Do you like smokes? I like smokes."
Choosing a pack of Camels in the store, a 4-year-old girl said, "I need this for my man. A man needs cigarettes."
A 6-year-old boy pointed to cigarettes in the store and said, "I’m definitely not going to buy those; they can kill you."
It is well-known that children of parents who smoke or drink alcohol are more likely to adopt those habits themselves, Dalton said. "This study provides a little insight into why that might be," she explained. "Children are developing these perceptions really early in life and they’re unquestioned beliefs that they carry through to later in life."
The message for parents in all this is clear, said Dalton, who has children herself.
"It’s really important to be mindful of your behavior and the messages your behavior is sending your children," she said. "Parents shouldn’t smoke at all, but if they do, they shouldn’t smoke around their children. It’s bad for their own health and their children’s health, and it’s also bad modeling behavior."
The message for alcohol is a bit more complicated, she noted, because moderate drinking is not harmful and may actually have health benefits. However, parents can make sure that alcohol isn’t the focus of socialization or coping. "It’s important to provide that balance," she said.