Promoting a tobacco-free generation: who is responsible for what?

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Abstract
The aim of the study was to investigate how adolescents, parents and school staff look upon different agents' responsibilities in relation to the goal 'a tobacco-free generation'. This study was part of a larger study and used a descriptive, cross-sectional three-group design with questionnaires as the means of data collection. The sample comprised 216 pupils in grade five (11 years old) and 225 pupils in grade eight (14 years old) in a south-western county in Sweden, 293 of their parents and 119 school staff (headteachers, teachers, school nurses). All respondents agreed that adults should take a clear stand against adolescent tobacco use. The adolescents ranked their parents as the number one source of tobacco information, while pupils, parents, teachers and headmasters ranked school nurses at the bottom rank. The teaching at school focused on risks from tobacco use. The non-smoking norm at school was viewed differently by pupils, parents and school staff. The actions of family, school and society reflect the norms and these do influence adolescent smoking. The conclusion was that the responsibility to promote a tobacco-free generation was viewed differently by the categories involved in this study. The adolescents put the responsibility mainly on parents, while parents put it on the school, and the school staff on special health educators. Both parents and school staff need to recognize their importance in creating a non-smoking culture. To contribute to the creation of a non-smoking generation, school nurses should abandon their passive role in health promotion, as shown in this study, and instead engage in encouraging pupils, parents and teachers to remain or become tobacco-free.