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Randomized Controlled Trial
. 2011 Sep;140(3):681-689.
doi: 10.1378/chest.10-2609. Epub 2011 Apr 7.

Providing coaching and cotinine results to preteens to reduce their secondhand smoke exposure: a randomized trial

Melbourne F Hovell  1 , Dennis R Wahlgren  2 , Sandy Liles  2 , Jennifer A Jones  2 , Suzanne C Hughes  2 , Georg E Matt  3 , Ming Ji  4 , Christina N Lessov-Schlaggar  5 , Gary E Swan  6 , Dale Chatfield  7 , Ding Ding  2
Affiliations
Randomized Controlled Trial

Providing coaching and cotinine results to preteens to reduce their secondhand smoke exposure: a randomized trial

Melbourne F Hovell et al. Chest. 2011 Sep.

Abstract

Background: Secondhand smoke exposure (SHSe) poses health risks to children living with smokers. Most interventions to protect children from SHSe have coached adult smokers. This trial determined whether coaching and cotinine feedback provided to preteens can reduce their SHSe.

Methods: Two hundred one predominantly low-income families with a resident smoker and a child aged 8 to 13 years who was exposed to two or more cigarettes per day or had a urine cotinine concentration ≥ 2.0 ng/mL were randomized to control or SHSe reduction coaching groups. During eight in-home sessions over 5 months, coaches presented to the child graphic charts of cotinine assay results as performance feedback and provided differential praise and incentives for cotinine reductions. Generalized estimating equations were used to determine the differential change in SHSe over time by group.

Results: For the baseline to posttest period, the coaching group had a greater decrease in both urine cotinine concentration (P = .039) and reported child SHSe in the number of cigarettes exposed per day (child report, P = .003; parent report, P = .078). For posttest to month 12 follow-up, no group or group by time differences were obtained, and both groups returned toward baseline.

Conclusions: Coaching preteens can reduce their SHSe, although reductions may not be sustained without ongoing counseling, feedback, and incentives. Unlike interventions that coach adults to reduce child SHSe, programs that increase child avoidance of SHSe have the potential to reduce SHSe in all settings in which the child is exposed, without requiring a change in adult smoking behavior.

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Figures

Figure 1.
Figure 1.
Participant flow. BL = baseline; Ctrl = control; SHS = secondhand smoke; TC = target child; TP = target parent; Tx = treatment.
Figure 2.
Figure 2.
Validity correlations among biologic and reported measures related to secondhand smoke exposure (all P < .001). Correlations for TP reported exposure and bans are given in parentheses. See Figure 1 legend for expansion of abbreviations.
Figure 3.
Figure 3.
Change in cotinine (ng/mL) from baseline to posttest by experimental condition. Plots are of fitted values modeled by the generalized estimating equations procedure.
See this image and copyright information in PMC

References

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