Taking Care - Information on Smoking for Child Care Providers

Taking Care
Information on Smoking for Child Care Providers

by Jane Chapman, Nicholson Consultants, for the Women and Tobacco Reduction Program, Health Canada

Women today are smoking more than ever before, and they're paying the price. Every 35 minutes, a woman dies a preventable death due to smoking. The reasons why women smoke in the face of such risks include the stresses of work and family responsibilities and social pressures to stay thin. Women working in the child care profession face a myriad of pressures on the job. For home child care providers, there are often the added stresses of isolation and a lack of formal support. This article examines the health risks associated with smoking, some of the reasons why women smoke, and why child care providers may be particularly vulnerable. It also suggests some common-sense alternatives to smoking.

Why Women Smoke
When so much is known about its dangers, and when it is less and less socially acceptable, why do so many girls and women take up smoking and continue to smoke?

The reasons why women smoke are complex and interrelated. Smoking is often used to help deal with everyday stresses, including women's double workload of job and family responsibilities. Many women rely on smoking to help manage negative feelings of anger or frustration, as a means of gaining control when other areas of their lives seem out of control, or to nurture themselves when they are lonely or bored. In fact, some women identify smoking as one of the few things they do in the course of the day that is actually "for themselves." It's the friend who is always there, never makes demands and delivers the expected.

Maintaining an acceptable body weight is one of the main reasons women cite for both starting and maintaining the smoking habit. There are strong cultural pressures on women to be thin, and advertising and programming on television, in magazines and on billboards help to convey the "thin is in" message. Tobacco advertising and promotion have a long tradition of playing on women's desire to conform to perceived ideal images of feminine beauty -- particularly the ideal of slimness. Ads targeting girls and young women also emphasize fun, youth, freshness, independence and a sense of control. Some tobacco products, such as "slim" or "light" cigarettes, are designed to have special appeal to women.

Social and family relationships have a strong influence on determining whether women smoke. For women trying to quit or reduce smoking, living or spending time with people who smoke can make kicking the habit that much more difficult.
Smoking may also be used as a coping strategy -- or release valve -- for the effects of inequality that many women experience. Many women are in jobs that are under-valued by society. Women in low-paying jobs and those looking for work have very high smoking rates. Other high-priority groups, including francophone and aboriginal women, also have higher-than-average smoking rates.
What's at Risk
For Women:
Now the leading killer of women in Canada, smoking affects women's general and reproductive health. It increases the incidence of:

heart disease
lung cancer
stroke
cervical cancer
osteoporosis
premature birth, miscarriage and stillbirth
chronic lung diseases
throat cancer

What About Child Care Providers?
Perhaps more than most, child care providers have the proverbial "full plate." Caring for children, running a household, raising their own children, operating a day care business and managing clients -- all these place tremendous demands on a child care provider's time and patience. Not to mention the demands of being a partner, friend, daughter-in-law and member of the community. It's not surprising that many women feel that there isn't much left to give to themselves.

With increased responsibilities generally come higher stress levels. Add to that the fact that women tend not only to take on the world's problems, but take personal responsibilty for them as well. In this way, it becomes their fault if one child can't seem to get along with the others, or if another child doesn't get invited to a certain party.

Centre-based child care providers have the advantage of being able to communicate with colleagues on a daily basis. Caregivers who work out of their homes have the added stress of being isolated from other adults. Smoking can sometimes help to fill a void and provide a sense of adult activity in a day filled with children and child-related activities. Working at home also presents special challenges for women wanting to quit. For self-employed child care providers, there aren't any employer rules and policies to help restrict tobacco use, forcing child care providers to take on the extra task of setting non-smoking rules -- and implementing them.

The Stages of Change
When you get right down to it, reducing or quitting smoking is an individual thing -- the method that works best will depend on you. Many ex-smokers quit on their own. For others, self-help or group programs, nicotine replacements or alternative therapies such as hypnotism or acupuncture are the answer. A good starting point is to talk to a family doctor, or go to a community medical clinic or public health office. The local and provincial offices of the Lung Association, the Canadian Cancer Society, and the Canadian Heart and Stroke Foundation are also excellent sources of information. If you're searching for a group or self-help program, look for one that is woman-centred, that is, sensitive to women's particular needs and life experiences.

Regardless of the method used, all smokers pass through five basic stages of change in attempting to quit. It's important to remember that it isn't normally a straight path from one stage to the next. Most people cycle through these stages several times before quitting for good. Here's a brief look at the five stages of change:

Smokers at the precontemplation stage are not thinking seriously about quitting and, if challenged, will generally defend their smoking behaviour. They may be discouraged with previous attempts to quit or believe they're too addicted to change.
At the contemplation stage, people who smoke are considering quitting sometime in the near future (probably six months or less). They are aware of the personal consequences of their smoking, but may still doubt that the long-term benefits associated with quitting will outweigh the short-term costs.
People in the preparation stage have made the decision to quit and are getting ready to actually stop smoking. They see the cons of smoking as outweighing the pros and are taking small steps toward cessation. For example, they may be delaying their first cigarette of the day, or smoking fewer cigarettes.
The action stage is where the "rubber hits the road." People in this stage are actively trying to stop smoking, maybe using short-term rewards to sustain their motivation, and are likely looking to family and friends for support. This stage lasts about six months and sees smokers at the greatest risk of relapse.
Smokers in the maintenance stage have learned to anticipate and handle temptations to smoke and are able to use new ways of coping. Although they may slip and have a cigarette from time to time, they try to learn from the slip so it doesn't happen again.

Some Positive Alternatives
As a child care provider and a woman, it's easy to feel that life is actually living you, instead of the other way around. Keeping balance and control in a busy life requires taking action in positive, healthy ways, such as setting personal goals for achieving physical, intellectual and emotional well-being. A positive attitude is crucial to quitting: tell yourself "I can quit!" and leave notes reminding yourself why you want to quit. Following are some important ways that child care providers can care for themselves and help reduce or quit smoking too. Healthy Habits
Eating well and taking part in some type of regular physical activity are the foundations for good physical health. Good nutrition means eating the kinds of food that will provide energy for daily living, promote growth and repair, help prevent disease, and promote a sense of well-being.

Canada's Food Guide to Healthy Eating is a useful guideline to help make sensible food choices. It emphasizes a variety of foods from all four food groups and indicates a recommended number of servings per day as well as appropriate serving sizes. Following the Food Guide can also help women manage the relatively small weight gain that may occur after quitting smoking -- without resorting to ineffective and often unhealthy "crash" diets. (Canada's Food Guide is available free of charge from Health Canada -- call Publications (613) 954-5995 or Nutrition Programs (613) 957-8329.)

Drinking plenty of water (six to eight glasses per day) can help flush the nicotine out of your system. Try drinking from a straw or chewing crushed ice to satisfy your oral cravings.

Physical fitness is one of the keys to overall well-being. In addition to strengthening the heart, lungs, bones and muscles, it lessens anxiety and stress, and helps manage weight. The time demands of caregiving -- both professional and personal -- can make physical activity a low priority. Fortunately, child care provides plenty of opportunities for being physically active -- from taking a brisk walk around the block with the younger children in a stroller or wagon to joining the children in skating and sliding activities during the winter. More than most people who work, child care providers can take advantage of their work situation to stay fit.

In addition to exercise, relaxing your body with some deep breathing -- 10 deep breaths at a time -- can also help you cope with the urge to smoke.

Be Good to Yourself
To a large degree, emotional well-being depends on having a healthy attitude about yourself. To build positive self-esteem, look for opportunities to learn and grow by attending workshops, courses and conferences. Spend time doing things you enjoy, including being with friends or reading a book. If you're a home child care provider, don't stay cooped up with just the children all day -- take them out to a resource centre or community drop-in program, or arrange to get together with another care provider.

Get Support
For the home child care provider, one of the biggest stresses is dealing with problems and making decisions all on her own. There are no co-workers on hand to talk over a problem or share a laugh with. Talking to people with shared interests and concerns can go a long way in supporting home child care providers. Many communities may already have a child care provider association or support group. If not, try contacting government day care offices, child care resource centres, child care registries, home care agencies, child care support programs, toy libraries or local play groups and ask for the names of other caregivers in the area.

Talking to Children about Smoking
Whether your smoke or not, as a child care provider you're well-placed to exert a positive influence on children. Take the time to talk to the kids in your care about the benefits of staying smoke-free -- better health, more money to buy the things they want and the energy to take part in all kinds of physical activities. If you do smoke, be open and honest about why you started and how difficult it is to quit once you begin. Encourage kids to think ahead and plan how they will say "no" to smoking.

A primary source of information for this article was Caring for the Caregiver, Lee Dunster (1995), Child Care Providers Association, a project funded by the Women and Tobacco Reduction Program, Health Canada. For copies, write to: Child Care Providers Association, 333 Churchill Avenue, Ottawa, ON K1Z 5B8.

Nicholson Consultants is a private consulting firm contracted to assist Health Canada with the development of information materials on women and smoking.

This article first appeared in Interaction published by the Canadian Child Care Federation, Spring 1996.

Posted by: the Canadian Child Care Federation, September 1996.