A review of interventions for reduction of residential environmental tobacco smoke exposures among children
- PMID: 20084212
- PMCID: PMC2804511
- DOI: 10.1093/pch/6.2.70
A review of interventions for reduction of residential environmental tobacco smoke exposures among children
Abstract
Objective: To describe individual-level interventions to reduce residential environmental tobacco smoke (ETS) exposure among children and to summarize the evidence of the effectiveness of the interventions.
Patients and methods: A search of electronic databases (from 1987 to 1998) was conducted for studies designed to reduce ETS exposure of children through the use of interventions that included strategies other than parental smoking cessation. Twelve articles that presented nine unique interventions (six interventions were designed for well children and three interventions targeted children with asthma) were found. Information about location, target population, design, sample size, tested intervention and results were summarized for each study.
Results: Only one of the six interventions designed for well children produced significant reductions in ETS exposure, while all three of the interventions that targeted children with asthma reported small to moderate reductions in ETS exposure or respiratory symptoms.
Conclusions: The number of interventions for ETS reduction published to date is miniscule relative to the magnitude of the associated health problems. Some ETS reduction interventions for children have shown significant reductions in exposure, but most interventions, especially those designed for well children, have had little effect. Little is known about which specific intervention components may be effective. Parental characteristics that may predict positive response to intervention efforts have not been identified. More research is needed to develop effective interventions that can be integrated with physician visits in the perinatal and early childhood periods. Adapting standard guidelines on counselling for parental smoking cessation may be a promising approach if the barriers identified by health professionals can be addressed adequately.
OBJECTIF :: Décrire les interventions individuelles pour réduire la fumée secondaire en milieu résidentiel (FSR) auprès des enfants et résumer les observations relatives à leur efficacité.
PATIENTS ET MÉTHODES :: Une recherche a été menée dans les bases de données électroniques (entre 1987 et 1998) afin de trouver les études conçues pour réduire l’exposition des enfants à la FSR par d’autres stratégies d’intervention que de convaincre les parents d’arrêter de fumer. On a découvert douze articles exposant neuf interventions uniques (six destinées aux enfants en santé et trois, aux enfants asthmatiques). L’information sur le lieu, la population ciblée, la méthodologie, la dimension de l’échantillon, les interventions mises à l’essai et les résultats a été résumée pour chaque étude.
RÉSULTATS :: Une seule des six interventions conçues pour les enfants en santé a découlé en une réduction substantielle de l’exposition à la FSR, tandis que trois des interventions visant à réduire l’exposition à la FSR ou les symptômes respiratoires auprès des enfants asthmatiques ont donné des résultats minimes à moyens.
CONCLUSIONS :: Le nombre d’interventions pour réduire la FSR publiées jusqu’à maintenant est minuscule relativement à la magnitude des problèmes de santé connexes. Certaines interventions pour réduire la FSR auprès des enfants ont permis de diminuer cette exposition de manière marquée, mais la plupart d’entre elles, surtout si elles visaient des enfants en santé, ont eu peu d’effets. On ne sait pas vraiment quels éléments de chaque intervention sont efficaces. On n’a pas repéré les caractéristiques parentales susceptibles de favoriser une réponse positive aux efforts d’intervention. Des recherches supplémentaires s’imposent donc pour élaborer des interventions efficaces pouvant être intégrées aux soins de santé systématiques pendant la période périnatale et la petite enfance. L’adaptation de directives normalisées sur le counseling afin d’inciter les parents à arrêter de fumer pourrait constituer une démarche prometteuse si les obstacles repérés par les professionnels de la santé sont éliminés de manière pertinente.
Keywords: Environmental tobacco smoke; Interventions; Paediatrics; Parental behaviour; Passive smoking; Respiratory illness.
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