Mother-daughter communication: A protective factor for nonsmoking among rural adolescents

Rural adolescent females are at-risk for smoking at rates nearly equal to those of boys, and girls are at increased risk for smoking related diseases, reproductive, and pregnancy problems. The purpose of this study was to investigate protective factors related to nonsmoking in African American (AA) and Caucasian American (CA) female adolescents residing in rural tobacco-producing counties in Virginia. This qualitative study targeted rural female adolescent nonsmokers and their parents because of the importance of promoting tobacco-free, healthy lifestyles into adulthood. Participants were 18 adolescent female nonsmokers 16-17 years of age (6 AA and 12 CA) and 10 mothers (5 AA and 5 CA). Semi-structured questionnaires based on a health behavior framework and communication theory guided four in-depth group interviews of female adolescents and two group interviews of mothers. Protective factors identified by youth and parent groups were: frequent and open communication about smoking dangers and risks, mothers' intentionality in messages about nonsmoking; repeated patterns of oversight of daughter's activities and friends; mothers' pride in their daughters; close knit family of support; and daughter's explicit desire not to disappoint their parents. Directions for future research include the nature and type of female adolescents' communication with parents and a parallel study of protective factors of tobacco-free rural male adolescents to design parent-child communication interventions for tobacco prevention.