title: Use of cigarettes and alcohol by preschoolers while role-playing as adults: "Honey, have some smokes".
abstract: OBJECTIVE
  To examine preschoolers' attitudes, expectations, and perceptions of tobacco and alcohol use.
  
  
  METHODS
  Structured observational study. Children used props and dolls to act out a social evening for adults. As part of the role play, each child selected items from a miniature grocery store stocked with 73 different products, including beer, wine, and cigarettes, for an evening with friends.
  
  
  METHODS
  A behavioral laboratory at the Department of Psychological and Brain Sciences, Dartmouth College.
  
  
  METHODS
  One hundred twenty children, 2 to 6 years old, participated individually in the role-playing.
  
  
  METHODS
  Whether or not a child purchased cigarettes or alcohol at the store.
  
  
  RESULTS
  Children purchased a mean of 17 of the 73 products in the store. Thirty-four children (28.3%) bought cigarettes and 74 (61.7%) bought alcohol. Children were more likely to buy cigarettes if their parents smoked (adjusted odds ratio [OR], 3.90; 95% confidence interval [CI], 1.20-12.63). Children were more likely to buy beer or wine if their parents drank alcohol at least monthly (adjusted OR, 3.04; 95% CI, 1.02-9.10) or if they viewed PG-13- or R-rated movies (adjusted OR, 5.10; 95% CI, 1.14-22.90). Children's play behavior suggests that they are highly attentive to the use and enjoyment of alcohol and tobacco and have well-established expectations about how cigarettes and alcohol fit into social settings.
  
  
  CONCLUSIONS
  The data suggest that observation of adult behavior, especially parental behavior, may influence preschool children to view smoking and drinking as appropriate or normative in social situations. These perceptions may relate to behaviors adopted later in life.
authors.affiliation: Department of Pediatrics, Dartmouth Medical School, Norris Cotton Cancer Center, Lebanon, NH 03756, USA. Madeline.Dalton@Dartmouth.edu
authors.forename: Madeline A
authors.initials: MA
authors.lastname: Dalton
authors.forename: Amy M
authors.initials: AM
authors.lastname: Bernhardt
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Gibson
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
authors.forename: Michael L
authors.initials: ML
authors.lastname: Beach
authors.forename: Anna M
authors.initials: AM
authors.lastname: Adachi-Mejia
authors.forename: Linda T
authors.initials: LT
authors.lastname: Titus-Ernstoff
authors.forename: Todd F
authors.initials: TF
authors.lastname: Heatherton
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000523:psychology*; D001294:Attitude to Health; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D009513:New Hampshire; D010290:Parents / Q000523:psychology; D010988:Play and Playthings; D012309:Risk-Taking; D012381:Role Playing; D012907:Smoking / Q000523:psychology*; D012925:Social Conformity; D012931:Social Environment; D012938:Social Perception; D011795:Surveys and Questionnaires