title: Effectiveness of Interventions to Reduce Tobacco Smoke Pollution in Homes: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Smoke-free homes can help protect children from tobacco smoke exposure (TSE). The objective of this study was to conduct a meta-analysis to quantify effects of interventions on changes in tobacco smoke pollution in the home, as measured by air nicotine and particulate matter (PM).
  
  
  METHODS
  We searched MEDLINE, PubMed, Web of Science, PsycINFO, and Embase. We included controlled trials of interventions which aimed to help parents protect children from tobacco smoke exposure. Two reviewers identified relevant studies, and three reviewers extracted data.
  
  
  RESULTS
  Seven studies were identified. Interventions improved tobacco smoke air pollution in homes as assessed by nicotine or PM. (6 studies, N = 681, p = 0.02). Analyses of air nicotine and PM separately also showed some benefit (Air nicotine: 4 studies, N = 421, p = 0.08; PM: 3 studies, N = 340, p = 0.02). Despite improvements, tobacco smoke pollution was present in homes in all studies at follow-up.
  
  
  CONCLUSIONS
  Interventions designed to protect children from tobacco smoke are effective in reducing tobacco smoke pollution (as assessed by air nicotine or PM) in homes, but contamination remains. The persistence of significant pollution levels in homes after individual level intervention may signal the need for other population and regulatory measures to help reduce and eliminate childhood tobacco smoke exposure.
authors.affiliation: School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O.B. 39040, Ramat Aviv 69978, Israel. rosenl@post.tau.ac.il.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Rosen
authors.affiliation: School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O.B. 39040, Ramat Aviv 69978, Israel. vicki_myers@hotmail.com.
authors.forename: Vicki
authors.initials: V
authors.lastname: Myers
authors.affiliation: Massachusetts General Hospital and Harvard Medical School, Boston, MA 02451-1137, USA. jwinickoff@mgh.harvard.edu.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Winickoff
authors.affiliation: Sackler School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, P.O.B 39040, Ramat Aviv 69978, Israel. jeffreykott@gmail.com.
authors.forename: Jeff
authors.initials: J
authors.lastname: Kott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016902:Air Pollution, Indoor / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000032:analysis*; D010290:Parents / Q000523:psychology*; D052638:Particulate Matter / Q000032:analysis*; D016540:Smoking Cessation / Q000379:methods*; D014028:Tobacco Smoke Pollution / Q000032:analysis* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D052638:Particulate Matter; D014028:Tobacco Smoke Pollution; D009538:Nicotine
keywords: air nicotine; environmental tobacco smoke (ETS); home air quality; respirable small particles (RSPs); tobacco smoke exposure (TSE)