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Children Learning About Second-Hand Smoking: A Feasibility Cluster Randomized Controlled Trial.

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A school-based smoke-free intervention (SFI) effectively promoted smoke-free homes and reduced smoking in front of children in Bangladesh. The intervention showed a clear trend of increasing success with greater intensity, empowering children to negotiate healthier home environments.

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Area of Science:

  • Public Health
  • Environmental Health
  • Child Health

Background:

  • Second-hand smoke exposure poses significant health risks to children.
  • A school-based smoke-free intervention (SFI) was developed to address this issue in Bangladesh.
  • Preliminary evidence suggested the intervention's potential effectiveness.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of a school-based smoke-free intervention (SFI) in promoting smoke-free homes.
  • To assess the impact of SFI on reducing the social visibility of smoking in households with children.

Main Methods:

  • A cluster randomized controlled trial was conducted in 24 schools in Dhaka, Bangladesh.
  • Schools were assigned to SFI only, SFI plus reminders, or a control group.
  • Year-5 children (10-12 years old) completed surveys at baseline and follow-up points up to 52 weeks.

Main Results:

  • Significantly higher rates of smoke-free homes were observed in intervention arms compared to the control group at 1 year.
  • Reduced social visibility of smoking (smoking not occurring in front of children) was also significant in intervention arms.
  • A dose-response relationship was evident, with increased intervention intensity correlating with improved outcomes.

Conclusions:

  • The school-based smoke-free intervention demonstrates potential in creating healthier home environments.
  • Children can be empowered through such interventions to negotiate smoke-free spaces.
  • SFI is a promising strategy for reducing children's exposure to second-hand smoke.