Effectiveness of a brief primary care intervention to reduce passive smoking in babies: a cluster randomised clinical
Guadalupe Ortega Cuelva1, Carmen Cabezas Peña2, Jesús Almeda Ortega3
1Agència de Salut Pública de Catalunya (ASPCAT), Departament de Salut, Generalitat de Catalunya, Barcelona, Spain Fundació Atenció Primària de la CAMFiC, Barcelona, Spain.
Insights
A brief intervention helped parents reduce their babies' exposure to tobacco smoke pollution (TSP). Nicotine levels in infant hair decreased when parents adopted better TSP avoidance strategies.
Area of Science:
- Pediatrics
- Public Health
- Environmental Health
Background:
- Tobacco smoke pollution (TSP) significantly harms infant health.
- Primary care interventions are crucial for addressing infant exposure to TSP.
- Understanding factors contributing to infant TSP exposure is vital for developing effective prevention strategies.
Purpose of the Study:
- To evaluate the effectiveness of a brief primary care intervention in reducing infant TSP exposure.
- To identify variables associated with higher infant TSP exposure.
- To assess the impact of parental behavioral changes on infant nicotine levels.
Main Methods:
- A multicenter, open, cluster-randomized trial involving 1101 infants of smoking parents.
- Intervention group received a brief TSP intervention; control group received usual care.
- Outcomes measured via parental reported strategies, infant hair nicotine levels, and parental smoking behaviors.
Main Results:
- TSP-avoidance strategies improved significantly more in the intervention group compared to the control group.
- 78.7% of infants tested showed evidence of TSP exposure via nicotine in hair samples.
- Reduced nicotine concentration in infant hair correlated with improved parental TSP avoidance strategies.
Conclusions:
- The brief intervention successfully induced behavioral changes to reduce infant TSP exposure.
- A high proportion of infants exhibit concerning levels of nicotine exposure from tobacco smoke.
- Targeted interventions are effective in mitigating the negative health impacts of TSP on infants.
Background:
Tobacco smoke pollution (TSP) has major negative effects on infant health. Our objectives were to determine the effectiveness of a brief primary care intervention directed at parents who smoke in reducing babies' TSP exposure, and to establish variables related to greater exposure.
Method:
A multicentre, open, cluster-randomised clinical trial in Catalonia. The 83 participating primary health paediatric teams of the Catalan Health Service recruited 1101 babies whose parents were smokers. The intervention group (IG) received a brief TSP intervention; the control group (CG) received the usual care. Outcomes were measured by parents' reported strategies to avoid TSP exposure. Baseline clinical data and characteristics of each baby's TSP exposure were collected, along with infant hair samples and parents' tobacco use and related attitudes/behaviours. At 3-month and 6-month follow-up, behavioural changes to avoid TSP exposure were recorded; the association between reported parental behaviours and nicotine concentration in infant hair samples was tested in a random sample of 253 babies at baseline and 6 months.
Results:
During follow-up, TSP-avoidance strategies improved more in the IG than in the CG: 35.4% and 26.9% ( p=0.006) at home, and 62.2% and 53.1% in cars (p=0.008). Logistic regression showed adjusted ORs for appropriate measures in the IG versus CG of 1.59 (95% CI 1.21 to 2.09) at home and 1.30 (95% CI 0.97 to 1.75) in cars. Hair samples showed that 78.7% of the babies tested were exposed. Reduced nicotine concentration was associated with improved implementation of effective strategies reported by parents at home (p=0.029) and in cars (p=0.014).
Conclusions:
The intervention produced behavioural changes to avoid TSP exposure in babies. The proportion of babies with nicotine (>=1ng/mg) in hair samples at baseline is a concern.
Trial Registration Number:
Clinical Trials.gov Identifier: NCT00788996.
More Related Videos
07:11Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling
Published on: February 5, 2019
09:50Impact Assessment of Repeated Exposure of Organotypic 3D Bronchial and Nasal Tissue Culture Models to Whole Cigarette Smoke
Published on: February 12, 2015
Related Concept Videos
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Preventive Healthcare Services
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
01:20Lifestyle Factors and Health
Benefits of Physical Activity
Physical activity, whether through structured exercise or casual activities like walking, biking, or dancing, is a cornerstone of a...