Radon-smoking synergy: A population-based behavioral risk reduction approach

Area of Science:

• Environmental Health
• Public Health
• Behavioral Science

Background:

• Radon and cigarette smoking exhibit a synergistic, multiplicative effect on lung cancer incidence.
• Smokers and residents of smoking households face elevated lung cancer risk, even at lower radon concentrations.
• A behavioral risk reduction strategy focusing on smoking cessation is proposed.

Purpose of the Study:

• To evaluate a behavioral risk reduction strategy for households with combined radon and smoking exposure.
• To assess the effectiveness of different intervention methods (written materials vs. telephone counseling) in reducing smoking.
• To determine the efficacy of using public utility billing systems for recruiting at-risk households.

Main Methods:

• Pilot studies involving radon testing, interviews, questionnaires, and focus groups informed the intervention design.
• A three-arm randomized intervention trial was conducted, comparing written materials and telephone counseling.
• Households were recruited by offering free radon test kits via utility company billing; follow-up was via mail and phone.

Main Results:

• 1,220 out of 2,600 estimated smoking households requested radon test kits, with 714 randomized.
• Brief telephone counseling significantly increased smoking cessation rates compared to written materials alone.
• Telephone counseling was also associated with other risk reduction behaviors, such as household smoking bans.

Conclusions:

• Public utility billing systems are effective for recruiting households at risk from radon-smoking synergy.
• Brief telephone counseling surpasses written materials for smoking reduction and promoting indoor smoking bans.
• Improved methods are needed to educate smokers about the amplified lung cancer risk from radon exposure.