title: Providing coaching and cotinine results to preteens to reduce their secondhand smoke exposure: a randomized trial.
abstract: BACKGROUND
  Secondhand smoke exposure (SHSe) poses health risks to children living with smokers. Most interventions to protect children from SHSe have coached adult smokers. This trial determined whether coaching and cotinine feedback provided to preteens can reduce their SHSe.
  
  
  METHODS
  Two hundred one predominantly low-income families with a resident smoker and a child aged 8 to 13 years who was exposed to two or more cigarettes per day or had a urine cotinine concentration ≥ 2.0 ng/mL were randomized to control or SHSe reduction coaching groups. During eight in-home sessions over 5 months, coaches presented to the child graphic charts of cotinine assay results as performance feedback and provided differential praise and incentives for cotinine reductions. Generalized estimating equations were used to determine the differential change in SHSe over time by group.
  
  
  RESULTS
  For the baseline to posttest period, the coaching group had a greater decrease in both urine cotinine concentration (P = .039) and reported child SHSe in the number of cigarettes exposed per day (child report, P = .003; parent report, P = .078). For posttest to month 12 follow-up, no group or group by time differences were obtained, and both groups returned toward baseline.
  
  
  CONCLUSIONS
  Coaching preteens can reduce their SHSe, although reductions may not be sustained without ongoing counseling, feedback, and incentives. Unlike interventions that coach adults to reduce child SHSe, programs that increase child avoidance of SHSe have the potential to reduce SHSe in all settings in which the child is exposed, without requiring a change in adult smoking behavior.
authors.affiliation: Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA. Electronic address: mhovell@projects.sdsu.edu.
authors.forename: Melbourne F
authors.initials: MF
authors.lastname: Hovell
authors.affiliation: Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA.
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Wahlgren
authors.affiliation: Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA.
authors.forename: Sandy
authors.initials: S
authors.lastname: Liles
authors.affiliation: Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Jones
authors.affiliation: Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA.
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Hughes
authors.affiliation: Graduate School of Public Health, Department of Psychology, San Diego State University, San Diego, CA.
authors.forename: Georg E
authors.initials: GE
authors.lastname: Matt
authors.affiliation: Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA.
authors.forename: Ming
authors.initials: M
authors.lastname: Ji
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO.
authors.forename: Christina N
authors.initials: CN
authors.lastname: Lessov-Schlaggar
authors.affiliation: Center for Health Sciences, SRI International, Menlo Park, CA.
authors.forename: Gary E
authors.initials: GE
authors.lastname: Swan
authors.affiliation: Department of Chemistry, San Diego State University, San Diego, CA.
authors.forename: Dale
authors.initials: D
authors.lastname: Chatfield
authors.affiliation: Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA.
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D002648:Child; D003367:Cotinine / Q000652:urine*; D003376:Counseling; D004781:Environmental Exposure / Q000517:prevention & control; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D009042:Motivation; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine