Parental smoking and pretend smoking in young children

To investigate whether parental smoking was associated with smoking-related play behaviour in young children.

Children were asked to pretend that they were grown-ups having dinner. They were invited to act out this situation in a play corner with a toy kitchen and a child-sized dining area, including a package of fake cigarettes on the table.

Children were tested individually at their school during regular school hours.

The sample consisted of 100 children between 4 and 8 years of age (mean=5.28, SD=0.94) of which 57% were boys. The majority of the children were born in The Netherlands (99%).

The main outcome measure was whether or not a child pretended to be smoking a cigarette. Child and parent reports were used to assess parental smoking.

Findings revealed that 37% of the children had at least one 'puff' during their play. Children were more likely to pretend to smoke if they reported having smoking parents (OR=3.16, p=0.02; 95% CI=1.22 to 8.18). Analyses for the model with parent reports on parental smoking did not yield any direct association. Children's explicit attitudes were unrelated to their smoking-related play behaviour.

These findings indicate that young children, who reported having parents who smoke, already associate having dinner with a (after-dinner) cigarette.