Counseling to reduce children's secondhand smoke exposure and help parents quit smoking: a controlled trial.
BACKGROUND
We tested a combined intervention to reduce children's secondhand smoke exposure (SHSe) and help parents quit smoking.


METHODS
After baseline, mothers who exposed their children younger than 4 years to 10 or more cigarettes/week were randomized to the intervention (n = 76) or usual care control condition (n = 74). Outcomes were assessed at 3, 6, 12, and 18 months. Intervention families were offered 10 in-person at home and 4 telephone counseling sessions over 6 months, and additional pre- and postquit telephone sessions. Counseling procedures included behavioral contracting, self-monitoring, and problem solving.


RESULTS
Parents' reports of their smoking and children's exposure showed moderate and significant correlations with children's urine cotinine levels and home air nicotine (r = .40-.78). Thirteen (17.1%) intervention group mothers and 4 (5.4%) controls reported that they quit smoking for 7 days prior to 1 or more study measurements, without biochemical contradiction (p = .024). Results of generalized estimating equations showed significantly greater decrease in reported SHSe and mothers' smoking in the counseled group compared with controls. Reported indoor smoking and children's urine cotinine decreased, yet group differences for changes were not significant.


CONCLUSIONS
Nicotine contamination of the home and resulting thirdhand exposure may have contributed to the failure to obtain a differential decrease in cotinine concentration. Partial exposure to counseling due to dropouts and lack of full participation from all family members and measurement reactivity in both conditions may have constrained intervention effects. Secondhand smoke exposure counseling may have been less powerful when combined with smoking cessation.
Hovell
Melbourne F
MF
San Diego State University, Graduate School of Public Health, San Diego, CA, USA. mhovell@projects.sdsu.edu
Zakarian
Joy M
JM
Matt
Georg E
GE
Liles
Sandy
S
Jones
Jennifer A
JA
Hofstetter
C Richard
CR
Larson
Sarah N
SN
Benowitz
Neal L
NL
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D002140:California; D002675:Child, Preschool; D003367:Cotinine / Q000652:urine; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019570:Inhalation Exposure / Q000009:adverse effects / Q000517:prevention & control*; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000193:education* / Q000523:psychology; D040242:Risk Reduction Behavior; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000517:prevention & control*
D014028:Tobacco Smoke Pollution; D003367:Cotinine