Effect of counselling mothers on their children's exposure to environmental tobacco smoke: randomised controlled trial

Hovell, Melbourne F.; Zakarian, Joy M.; Matt, G.; Hofstetter, C. Richard; Bernert, John T.; Pirkle, James L.

doi:10.1136/bmj.321.7257.337

Cited by 153 publications

(117 citation statements)

References 20 publications

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“…This explains the high concentration values in the frequency distribution of the children from ''nonsmoking'' households ( Figure 1). This discrepancy between parents' report of their children's ETS exposure and the actual ETS exposure, as for example assessed by urinary cotinine levels, was also found in a recent intervention study (Hovell et al, 2000). Mothers' reports of their children's exposure to their smoking declined in a group that was counselled for over 3 months to reduce their children's ETS exposure from 27.3 (baseline) to 4.47 (after 3 months) and 3.66 cigarettes/week (after 12 months).…”

Section: Etsmentioning

confidence: 63%

“…In contrast to this, the urinary cotinine levels of the children from counselled mothers were 10.93 (baseline), 12.65 (after 3 months), and 10.47 ng/ml (after 12 months). The corresponding cotinine levels of the children from the control mothers were 9.43, 13.88 and 17.47 ng/ml (Hovell et al, 2000). We decided not to restrict the analysis to the subgroup of children with home visits where we could clean up the data, because this would mean restricting the analysis to a biased subgroup.…”

Section: Etsmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of children's exposure to environmental tobacco smoke (ETS): A study in Southern Germany

Scherer

Krämer

Meger-Kossien

et al. 2004

J Expo Sci Environ Epidemiol

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Maternal smoking has been repeatedly found to be the most important determinant of children's exposure to environmental tobacco smoke (ETS). Here, we further investigated predictors for the urinary cotinine/creatinine ratio (CCR, ng/mg) in 1220 preschool children for the year 1996. Children from smoking homes (35.1%) had significantly higher CCR than children from nonsmoking homes (mean: 55.5 vs. 14.9 ng/mg). The level of education of the parents was a strong predictor for CCRs even after adjusting for number of cigarettes smoked, maternal smoking and dwelling space. Additionally, dwelling space was inversely related to children's urinary cotinine level. The CCR-levels in children investigated in 1996 and 1998 were significantly correlated (Pearson's r ¼ 0.67). The parents of 806 children agreed for a visit to their homes. In 79 of the 536 (14.7%) of the self-reported, nonsmoking households, smoking was admitted during the visit. The mean urinary CCR of these children was 25.2 ng/mg. We conclude that in addition to parental smoking behaviour, other variables such as dwelling space and social and educational status predict the children's exposure to ETS. Our data also revealed that a considerable percentage of parents denied the ETS exposure of their children at home.

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Section: Etsmentioning

confidence: 63%

Section: Etsmentioning

confidence: 99%

Determinants of children's exposure to environmental tobacco smoke (ETS): A study in Southern Germany

Scherer

Krämer

Meger-Kossien

et al. 2004

J Expo Sci Environ Epidemiol

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“…Such trials are important in the context of the studies successfully completed in the last 20 years showing that SHS exposure can be reduced when families are coached to do so (Hovell et al, 1994(Hovell et al, , 2000(Hovell et al, , 2002(Hovell et al, , 2009Klepeis et al, 2013;Meltzer, Hovell, Meltzer, Atkins, & de Peyster, 1993).…”

Section: Continuedmentioning

confidence: 99%

Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

Daffa

Liles

Jackson

et al. 2014

Nicotine &Amp; Tobacco Research

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We examined homes of hookah-only smokers and nonsmokers for levels of indoor air nicotine (a marker of secondhand smoke) and indoor surface nicotine (a marker of thirdhand smoke), child uptake of nicotine, the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and the toxicant acrolein by analyzing their corresponding metabolites cotinine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and NNAL-glucuronides (total NNAL) and 3-hydroxypropylmercapturic acid.

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“…[12][13][14][15][16][17][18][19][20][21][22][23] Only from 1 of those studies was a sustained reduction in exposure to environmental tobacco smoke, measured as cotinine levels, reported, and from another study a significant reduction in the number of unscheduled asthma visits was reported. 12,13 Collectively, these trials raise serious questions about whether it is prudent to continue to rely on anticipatory guidance to reduce children's exposure to tobacco smoke. Our failure to show a reduction in the gaseous phase of children's exposure to SHS by using a passive environmental intervention provides additional support for regulations to ban smoking in public places and residential settings to reduce children's exposure to tobacco smoke.…”

Section: Discussionmentioning

confidence: 99%

“…11 Numerous studies have tested the efficacy of anticipatory guidance to reduce SHS exposure for children, but the majority failed to show significant reductions in children's SHS exposure by using measurements of cotinine, a metabolite of nicotine, or improvements in asthma symptoms. [12][13][14][15][16][17][18][19][20][21][22][23] This problem might be overcome if there was a technology to reduce SHS exposure passively, such as highefficiency, particulate-arresting (HEPA) air cleaners.…”

mentioning

confidence: 99%

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

2010

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Exposure to secondhand smoke (SHS) is associated with asthma exacerbations in children. Anticipatory guidance has failed to reduce SHS in controlled trials. It is not known whether high-efficiency, particlearresting (HEPA) air cleaners can reduce SHS or improve asthma symptoms in children. WHAT THIS STUDY ADDS:HEPA air cleaners led to reductions in unscheduled asthma visits and fine airborne particle levels but not asthma symptoms or cotinine levels. HEPA air cleaners may be useful as part of a multifaceted strategy to reduce asthma morbidity among children. abstract OBJECTIVE:The goal was to test the effects of high-efficiency, particulatearresting (HEPA) air cleaners on unscheduled asthma visits and symptoms among children with asthma exposed to secondhand smoke. METHODS:We enrolled 225 eligible children who were 6 to 12 years of age, had physician-diagnosed asthma, and were exposed to Ն5 cigarettes per day. We conducted a double-blind, randomized trial. Children were assigned randomly to receive 2 active or inactive HEPA air cleaners. RESULTS:Of 225 enrolled children, 110 (49%) were assigned to the intervention group and 115 (51%) to the control group; 215 (95%) completed the trial. During the trial, there were 42 fewer unscheduled asthma visits among children in the intervention group (18.5% [95% confidence interval: 1.25%-82.75%]; P ϭ .043), compared with those in the control group, after adjustment for baseline differences. There was a significant difference in the reductions of levels of particles of Ͼ0.3 m according to group assignment; there was a 25% reduction in particle levels in the intervention group, compared with a 5% reduction in the control group (P ϭ .026). There were no significant differences in parent-reported asthma symptoms, exhaled nitric-oxide levels, air nicotine levels, or cotinine levels according to group assignment. CONCLUSIONS:These results hold promise for using HEPA air cleaners as part of a multifaceted strategy to reduce asthma morbidity, but further research is necessary before they can be recommended routinely for the medical management of asthma.

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Effect of counselling mothers on their children's exposure to environmental tobacco smoke: randomised controlled trial

Cited by 153 publications

References 20 publications

Determinants of children's exposure to environmental tobacco smoke (ETS): A study in Southern Germany

Determinants of children's exposure to environmental tobacco smoke (ETS): A study in Southern Germany

Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

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