The potential for early parenting services to deliver family-based interventions for a smoke-free home

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𝘉𝘢𝘤𝘬𝘨𝘳𝘰𝘶𝘯𝘥 Smoking has implications for the health of parents and children. Although adult smoking has decreased, parents who quit or reduce smoking during pregnancy may be at risk of relapse after birth. In Australia, parents can seek help with parenting challenges through early parenting services (EPS). 𝘈𝘪𝘮𝘴 𝘢𝘯𝘥 𝘰𝘣𝘫𝘦𝘤𝘵𝘪𝘷𝘦𝘴 To explore the potential for early parenting services to take a family-based approach to reduce smoking-related risks for children and their families. 𝘔𝘦𝘵𝘩𝘰𝘥𝘴 The project used a multimethod design. Systematic literature reviews were conducted for family-based interventions for smoking cessation, reduction, and environmental tobacco smoke reduction. Semi-structured interviews were used to describe the smoking-related beliefs and behaviours of parents and their perspectives on interventions. A survey was used to explore parental smoking-related behaviours and factors associated with smoking. A workshop on the project findings was held with stakeholders from the early parenting services to elicit their perspectives on barriers and facilitators to family-based approaches and interventions. Life course and ecological models informed the analysis and interpretation of project findings. 𝘍𝘪𝘯𝘥𝘪𝘯𝘨𝘴 Studies of family-based interventions from across the childhood life course were heterogeneous and infrequently informed by life course or ecological models or frameworks. Qualitative analysis of interview data reflected themes of parenthood as a motivator to take action to reduce risk from smoking, motivated by perceptions of risk to the infant, the ideal of good parenting, and shame and stigma regarding smoking. Lapses in smoking cessation or rules about smoking occurred when experiencing difficulties with parenting and other stressors. Mothers expected that early parenting services would ask about smoking and would offer assistance. Low recruitment to the survey (N = 58) limited inferential analysis. Few respondents were smoking currently. Most parents indicated that they were experiencing lower than expected parenting confidence. Participants of the stakeholder workshop recognised the strengths of EPS to intervene with families due to their focus on parenting self-efficacy, family wellbeing, and reputation as trusted sources of information. Difficulties were encountered in the recruitment of fathers as participants for the interviews and survey, and thus most participants were mothers. The COVID-19 pandemic impacted the parent survey and stakeholder workshop. 𝘊𝘰𝘯𝘤𝘭𝘶𝘴𝘪𝘰𝘯 Early parenting services have strengths in intervening with parents and are well placed to innovate further in this area of child and family health. Future research and practice development is needed to explore opportunities for intervening with fathers who smoke in diverse social contexts.
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