A randomised controlled trial of a complex intervention to reduce children's exposure to secondhand smoke in the home.

Abstract:

OBJECTIVES:Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. We report a trial of a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking. DESIGN:An open-label, parallel, randomised controlled trial. SETTING:Deprived communities in Nottingham City and County, England PARTICIPANTS: Caregivers resident in Nottingham City and County in England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home. INTERVENTIONS:We compared a complex intervention combining personalised feedback on home air quality, behavioural support and nicotine replacement therapy for temporary abstinence with usual care. MAIN OUTCOMES:The primary outcome was change in air quality in the home, measured as average 16-24  hours levels of particulate matter of  < 2.5  µm diameter (PM2.5), between baseline and 12 weeks. Secondary outcomes included changes in maximum PM2.5, proportion of time PM2.5 exceeded WHO recommended levels of maximum exposure of 25  µg/mg3, child salivary cotinine, caregivers' cigarette consumption, nicotine dependence, determination to stop smoking, quit attempts and quitting altogether during the intervention. RESULTS:Arithmetic mean PM2.5 decreased significantly more (by 35.2 %; 95%  CI 12.7% to 51.9 %) in intervention than in usual care households, as did the proportion of time PM2.5 exceeded 25  µg/mg3, child salivary cotinine concentrations, caregivers' cigarette consumption in the home, nicotine dependence, determination to quit and likelihood of having made a quit attempt. CONCLUSIONS:By reducing exposure to SHS in the homes of children who live with smokers unable or unwilling to quit, this intervention offers huge potential to reduce children's' tobacco-related harm. TRIAL REGISTRATION NUMBER:ISRCTN81701383.This trial was funded by the UK National Institute for Health Research (NIHR): RP-PG-0608-10020.

journal_name

Tob Control

journal_title

Tobacco control

authors

Ratschen E,Thorley R,Jones L,Opazo Breton M,Cook J,McNeill A,Britton J,Coleman T,Lewis S

doi

10.1136/tobaccocontrol-2016-053279

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

155-162

issue

2

eissn

0964-4563

issn

1468-3318

pii

tobaccocontrol-2016-053279

journal_volume

27

pub_type

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