Dr. Elena Ratschen, Rebecca Thorley and Professor Sarah Lewis, John Britton, Magdalena Opazo-Breton, Juleitte Cook, Tim Coleman and Laura Jones
Presenter(s)
Dr Elena Ratschen Senior Lecturer in Health Services Research, Department of Health Sciences, University of York
Abstract
Background:
Exposing children to secondhand tobacco smoke 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.
Methods:
In an open-label randomised controlled trial of 205 families from deprived communities in England, we compared a complex intervention combining personalised feedback on home air quality, behavioural support and nicotine replacement therapy (NRT) for temporary abstinence with usual care. Our primary outcome was change in air quality in the home, measured as average 16-to-24-hour levels of particulate matter of <2.5µm diameter (PM₂.₅), between baseline and 12 weeks. Secondary outcomes included changes in maximum PM₂.₅, proportion of time PM₂.₅ exceeded World Health Organisation (WHO) recommended levels of maximum exposure of 25µg/mg3, child salivary cotinine, caregivers’ cigarette consumption, nicotine dependence, determination to stop smoking, quit attempts and quitting altogether during the intervention.
Findings:
Geometric mean PM₂.₅ decreased significantly more (by 35.2%; 95%CI: 12.7-51.9%) in intervention than in usual care households, as did the proportion of time PM₂.₅ exceeded 25µg/mg3, child salivary cotinine concentrations, caregivers’ cigarette consumption in the home, nicotine dependence, determination to quit, and likelihood of having made a quit attempt.
