TB patients learning about second hand smoke (TBLASS): a pilot individual randomised controlled trial

Area of Science:

• Public Health
• Behavioral Science
• Infectious Disease Epidemiology

Background:

• Second Hand Smoke (SHS) exposure is a significant risk factor for tuberculosis (TB) development and poorer disease outcomes, primarily occurring within the household.
• High rates of male tobacco use in Pakistan, contrasted with near-equal male-female TB distribution, suggest significant health risks for women from household SHS exposure.

Purpose of the Study:

• To develop and evaluate a behavioral intervention, 'Smoke Free Homes' (SFH), designed to help tuberculosis patients establish smoke-free environments in their homes.
• To inform the design of a definitive trial by conducting a pilot randomized controlled trial (RCT) of the SFH intervention.

Main Methods:

• Development of the SFH intervention using a taxonomy of behavior change techniques and a logic model.
• A pilot individual randomized controlled trial (RCT) involving 150 newly registered pulmonary TB patients across two TB centers.
• Participants were randomized into two arms: 'individual based care' and 'individual based care' plus 'supplementary support'. The primary outcome was validated by the 'Urine Cotinine' test.

Main Results:

• The pilot study successfully recruited 150 participants and established a methodology for evaluating the SFH intervention.
• Qualitative data collection aimed to identify barriers and key drivers for creating smoke-free homes.
• The Urine Cotinine test was validated as the primary outcome measure for assessing smoke-free home status.

Conclusions:

• The SFH intervention shows promise for reducing SHS exposure in households of TB patients.
• Further research, including a definitive trial, is warranted to confirm the effectiveness of the SFH intervention.
• Ethical considerations and participant well-being were prioritized, with no financial incentives provided.