OBJECTIVES: Parent engagement in anti-smoking parenting practices was examined as a predictor of children's recalled exposure to these practices, the presence of pro-smoking risk factors in children's social environments, and children's odds of initiating smoking. METHODS: 1,032 parents reported level of engagement in a program that promoted anti-smoking parenting practices for 8-year-old children. 1,032 children were surveyed 6 months and 3 years post-intervention; they reported on exposure to anti-smoking parenting practices, pro-smoking risk factors, and initiation of smoking. RESULTS: If parents reported high engagement in anti-smoking socialization, children had significantly greater recall of anti-smoking parenting practices and significantly fewer pro-smoking risk factors up to 3 years post-intervention. If engagement was moderate or low, children had progressively lower odds of recalling anti-smoking parenting practices relative to controls and they were progressively less likely to differ from controls in exposure to pro-smoking risk factors at follow-up. CONCLUSIONS: Achieving full program implementation remains a significant challenge to home-based, parent-led approaches to smoking prevention. However, if parents fully engage in anti-smoking parenting practices, children demonstrate protective effects up to 3 years later
