title: Children Learning About Second-Hand Smoking: A Feasibility Cluster Randomized Controlled Trial.
abstract: BACKGROUND
  Exposure to second-hand smoke is a threat to children's health. We developed a school-based smoke-free intervention (SFI) to support families in implementing smoke-free homes in Bangladesh, and gathered preliminary evidence of its effectiveness.
  
  
  METHODS
  A feasibility cluster randomized controlled trial of SFI was conducted in 24 schools in Mirpur, an urban area within Dhaka. Using simple stratified randomization, schools were allocated to: Arm A (SFI only), Arm B (SFI plus reminders), and Arm C (the control group). A total of 781 year-5 children (10-12 years old) in the consenting schools, participated in the study. Outcomes including "smoke-free homes" and "social visibility" that is, not smoking in front of children at home were assessed through questionnaire-based children's surveys, administered by researchers, at baseline and at weeks 1, 12, 27, and 52 in all arms.
  
  
  RESULTS
  "Smoke-free homes" were significantly higher in Arm A (odds ratio [OR] = 4.8; 95% CI = 2.6-9.0) and in Arm B (OR = 3.9; 95% CI = 2.0-7.5) than in Arm C, when controlled for the baseline levels, at year 1. Similarly, "social visibility" was significantly reduced in Arm A (OR = 5.8; 95% CI = 2.8-11.7) and in Arm B (OR = 7.2; 95% CI = 3.3-15.9) than Arm C, when controlled for the baseline levels, at year 1. We observed an increasing trend (Cochrane Armitage test statistic [Z] = 3.8; p < .0001) in homes becoming smoke-free with increasing intensity of the intervention (control < Arm A < Arm B), and a decreasing trend (Z = -5.13; p < .0001) in social visibility at homes.
  
  
  CONCLUSIONS
  SFI has the potential to encourage children to negotiate a smoke-free environment in their homes.
authors: Department of Economics, University of Dhaka, Dhaka, Bangladesh; rumanah14@yahoo.com.
authors: Rumana
authors: R
authors: Huque
authors: Department of Health Sciences, University of York, York, UK;
authors: Omara
authors: O
authors: Dogar
authors: Leeds City Council, Leeds, UK;
authors: Ian
authors: I
authors: Cameron
authors: Office of the Director of Public Health, Leeds City Council, Leeds, UK;
authors: Heather
authors: H
authors: Thomson
authors: Centre for Population Health Sciences Medical School, University of Edinburgh, Edinburgh, UK;
authors: Amanda
authors: A
authors: Amos
authors: Department of Health Sciences/Hull York Medical School, University of York, York, UK.
authors: Kamran
authors: K
authors: Siddiqi
mesh_terms: D001459:Bangladesh; D002648:Child; D002652:Child Behavior / Q000523:psychology; D016000:Cluster Analysis; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007858:Learning; D008297:Male; D012572:School Health Services; D012574:Schools; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution