Impact of a multi-level intervention to prevent secondhand smoke exposure in schoolchildren: a randomized cluster community trial.
OBJECTIVE
To assess the effectiveness of a multi-level (individual, family, and school) school-based intervention to prevent the exposure to secondhand smoke (SHS) in a population of schoolchildren (12-14 years old).


METHODS
This was a community trial with cluster randomization of schools to an intervention and comparison group (ClinicalTrials.Gov identifier NCT01881607). The intervention targeted schoolchildren in Terrassa (Catalonia, Spain). We assessed SHS exposure in different settings and tobacco consumption by means of a questionnaire before and one year after the intervention.


RESULTS
We analyzed data from 1734 students with both baseline and follow-up data. The crude analysis showed that SHS exposure among students in the intervention group significantly decreased at school (-14.0%), at home (-19.9%), and on transportation (-21.8%). In the comparison group, SHS exposure significantly decreased only at home (-16.9%). After adjustment for potential confounders, the good accomplishment of the activities showed a possible trend towards a non-significant reduction in exposure at home, transportation, and leisure time.


CONCLUSIONS
While this school-based multi-level intervention had no overall effect in SHS exposure, the improvement of the activities focused on preventing SHS would be needed in order to achieve a significant decrease in the proportion of children exposed to SHS.
Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Global Clinical Epidemiology (DS&E), Novartis Farmacéutica, Barcelona, Spain.
Carles
C
Blanch
Esteve
E
Fernández
Jose M
JM
Martínez-Sánchez
Carles
C
Ariza
María J
MJ
López
Albert
A
Moncada
Anna
A
Schiaffino
Luis
L
Rajmil
Esteve
E
Saltó
José A
JA
Pascual
Manel
M
Nebot
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012574:Schools; D000074606:Smoking Prevention; D012931:Social Environment; D014028:Tobacco Smoke Pollution / Q000517:prevention & control* / Q000706:statistics & numerical data
D014028:Tobacco Smoke Pollution
Adolescent; Environmental tobacco smoke; Public health intervention; Schoolchildren; Secondhand smoke