An exploration of the effect of a tobacco-related harm reduction strategy on parents in the hard-to-reach population

Francesca Robertson

Research output: ThesisDoctoral Thesis

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[Truncated] The World Health Organisation has described tobacco smoking as a global epidemic responsible for the majority of preventable drug deaths. The effects of parental smoking on children are also irrefutably adverse, long reaching and include an increased likelihood of daily smoking during adulthood. The Australian response to smoking has been largely within the control and prevention modalities and have been successful in significantly reducing the incidence of smoking in the general population. These approaches have been less effective with people with factors that contribute to poverty and marginalisation such as Aboriginality, adverse childhood experiences and the experience of institutional care, mental illness or homelessness, factors that make them a ‘hard to reach’ cohort in terms of health promotion messages.

This study developed a smoking related intervention that attended to the particular exigencies of people in the hard to reach cohort and could be applied opportunistically when they were in contact with services, in this case services that were delivered by social workers and aimed to enhance parenting. The study designed the 4S strategy creatively synergising best-practice principles from harm reduction and service delivery to parents in the hard-to-reach cohort. The 4S Strategy is a staged process that requires at least four in-depth contacts. This strategy was implemented with twenty parents involved in Responsible Parenting Services, run by the Department for Child Protection in Western Australia. Mixed methodology was used: Qualitative methods were used to garner insights into factors that support continued, cessation or reduction in smoking in the home. Quantitative methods were used to measure change and to determine whether this was a result of the strategy. The Severity of Dependence Scale (SDS) was applied prior to the delivery of the strategy. Questions regarding smoking frequency and the Orientation to Life Questionnaire (OTL) were also applied prior to the strategy, and again six months later.

Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2012


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