A Qualitative Analysis of Observed Discussions about Tobacco Between African-American Maternal Caregivers and Their Early Adolescent Daughters

Introduction: Preventing youth tobacco use continues to be a public health priority. Parents can shape their child’s tobacco use by talking openly to their children and communicating their expectations and values about tobacco use. Few studies with racial/ethnic minority families have focused on parent-child discussions about tobacco yet they are disproportionately affected by tobacco-related health disparities. In addition, less attention has been given to the messages that parents communicate to their children. We addressed this gap by having African American maternal caregivers participate in a video-taped discussion with their early adolescent daughters about tobacco.

Methods: Twenty-five African American maternal caregivers and their early adolescent daughters participated. Adolescents’ mean age was 13.4 years (SD= 1.2 years; range 11-14). Caregivers mean age was 42.91 years (SD = 8.16; range 30-65). Twenty-eight percent of caregivers were married, 48% were single, 16% divorced, and 8% were legally separated. Dyads were presented with an open prompt to discuss tobacco for 7 minutes. We used a grounded theory research design (Creswell, 2006) and content analysis to code the transcripts. 

Results: Six themes emerged: (a) health risks; (b) family smoking experiences; (c) second-hand smoke; (d) reasons people smoke and non-health related reasons not to smoke; (e) tobacco knowledge and facts; and, (f) influences on youth smoking. As an example of the health risks theme, one girl said “I tell my friends all the time ‘Don’t do it cause it’s really bad. You can die early from that stuff. Get lung cancer.” When recounting a family smoking experience, a caregiver said, “Mommy’s been smoking since she was 14. That’s a long time…It’s really hard [to stop] because it’s habit forming.” When talking about second hand smoke, a girl said, “I do want ya’ll [mother and father] to stop smoking though, because everybody at school be like saying I smell like smoke, and I don’t like that.” Finally, when one girl asked her caregiver why she started smoking (reasons people smoke) the caregiver replied, “Um, some people say they like the taste, Jasmine [family member] did it to relive stress.” Although participants were not asked if they used tobacco, 20 out of 25 dyads talked about family members who used tobacco.

Conclusions: Our findings demonstrate that urban African American maternal caregivers and their early adolescent daughters openly talk about a variety of tobacco-related topics. Findings highlight the potential role of adolescent daughters’ in helping to shape the health behaviors of their maternal caregivers in addition to the role of parental influence on teen tobacco use. Our findings have useful implications for family-based tobacco prevention programs.