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Reducing tobacco smoke exposure in children aged below 4 years - a randomized controlled trial
Sabina Ulbricht1, Stefan Groß2, Christian Meyer1
1Institute of Social Medicine and Prevention, University Medicine Greifswald, Walther-Rathenau-Str. 48, D-17475 Greifswald, Germany.
Insights
This study successfully reached German households with smokers but found no significant effect of counseling on children's urine cotinine levels (CUCL). Further research is needed to improve intervention strategies for reducing secondhand smoke exposure.
Area of Science:
- Public Health
- Environmental Health
- Behavioral Science
Background:
- Secondhand smoke exposure in children is a significant public health concern.
- Effective interventions are needed to reduce children's exposure to environmental tobacco smoke.
- Assessing intervention reach and efficacy in population-based samples is crucial.
Purpose of the Study:
- To evaluate the recruitment success of a German population-based household sample.
- To test the effectiveness of a behavioral change counseling intervention using children's urine cotinine level (CUCL) feedback.
- To analyze the intervention's impact on reducing secondhand smoke exposure.
Main Methods:
- A randomized controlled trial was conducted with households containing children under 4 and smokers.
- The intervention group received CUCL feedback and counseling; the control group received a leaflet.
- Heckman's selection model was used to account for cotinine detection limits (10 ng/ml).
Main Results:
- The study demonstrated high reach within the target German population.
- No significant reduction in children's urine cotinine levels (CUCL) was observed in the intervention group compared to the control group.
- The change in CUCL from baseline to follow-up was not significantly different between groups.
Conclusions:
- The proactive recruitment strategy effectively reached the intended population.
- The tested behavioral change counseling intervention, including CUCL feedback, did not show a significant effect on reducing secondhand smoke exposure.
- Further research is warranted to develop more effective interventions for reducing children's exposure to environmental tobacco smoke.
Objective:
To explore the reach of a German population-based household sample using proactive recruitment and to test the efficacy of a behavioral change counseling intervention including feedback about children's urine cotinine level (CUCL).
Methods:
A randomized controlled trial (2008-2010) was conducted in households with at least one child aged below 4years and at least one current smoker. The study area comprised of 3570 households. A screening assessment was provided in 2641 households; 1282 included one current smoker and 852 completed the study protocol. The intervention group (IG; n=428) received feedback about CUCL and up to two counseling sessions. The control group (CG; n=424) received a leaflet. Assessments were provided at baseline and 12-month follow-up. Heckman's selection model analysis was used to consider the detection limit of cotinine in urine (10ng/ml).
Results:
CUCL below the detection limit in the IG was found in 43.2% at baseline and 44.6% at follow-up and in 44.8% of the CG at baseline and 47.2% at follow-up. The CUCL difference between follow-up and baseline was smaller in the CG than in the IG. The effect was not significant.
Conclusions:
Data revealed a high reach of the target population but failed to identify an intervention effect. Clinical Trial Registration www.clinicaltrials.gov (NCT00647413).
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