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Reduction of environmental tobacco smoke exposure among asthmatic children: a controlled trial
M F Hovell1, S B Meltzer, J M Zakarian
1Center for Behavioral Epidemiology, Graduate School of Public Health, San Diego State University, USA.
Insights
A behavioral medicine program significantly reduced environmental tobacco smoke (ETS) exposure in homes for children with asthma. This intervention showed a sustained 51% decrease in exposure over 12 months.
Area of Science:
- Environmental Health
- Pediatric Asthma Management
- Behavioral Medicine
Background:
- Asthma in children is often exacerbated by exposure to environmental tobacco smoke (ETS).
- Reducing ETS exposure in the home is crucial for improving asthma control in pediatric populations.
- Previous interventions have shown varying success in modifying parental smoking behaviors and reducing child exposure.
Purpose of the Study:
- To evaluate the effectiveness of a behavioral medicine program in reducing home environmental tobacco smoke (ETS) exposure for children with asthma.
- To compare the efficacy of a counseling intervention against monitoring and usual care control groups.
Main Methods:
- A randomized clinical trial involving 91 families with asthmatic children recruited from allergy clinics.
- Families were assigned to an experimental counseling group, a monitoring control group, or a usual treatment control group.
- Intervention included 6 months of counseling to decrease ETS exposure, with repeated measures over 1 year.
Main Results:
- The experimental group achieved a 79% decrease in ETS exposure, significantly greater than the monitoring (42%) and usual care (34%) groups.
- Objective measures (nicotine air monitor) and parent reports confirmed reduced exposure.
- At 12 months, the experimental group maintained a 51% reduction in ETS exposure, compared to 18% and 15% in control groups.
Conclusions:
- A behavioral medicine intervention is effective in significantly reducing home environmental tobacco smoke (ETS) exposure for asthmatic children.
- The counseling program demonstrated sustained effectiveness in lowering ETS exposure over a 1-year period.
- This approach offers a viable strategy for improving asthma management through environmental modification.
Study Objective:
This randomized clinical trial tested a behavioral medicine program designed to reduce asthmatic children's exposure to environmental tobacco smoke (ETS) in the home.
Design:
Families were randomly assigned to an experimental preventive medicine counseling group, a monitoring control group, or a usual treatment control group. Families were measured six times over 1 year.
Participants:
Ninety-one families were recruited from four allergy clinics.
Intervention:
The experimental group received a 6-month series of counseling sessions designed to decrease ETS exposure. This group also monitored smoking, exposure, and children's asthma symptoms. The monitoring group did not receive counseling and the usual treatment control group received outcome measures only.
Measurements And Results:
Parents reported the daily number of cigarettes children were exposed to during the week preceding interviews. A nicotine air monitor and construct validity analysis confirmed the validity of exposure reports. Exposure to the parent's cigarettes in the home decreased for all groups. The experimental group attained a 79 percent decrease in children's ETS exposure, compared with 42 percent for the monitoring control and 34 percent for the usual treatment control group. Repeated-measures analysis of variance resulted in a significant (F([10,350] = 1.92, p < 0.05) group by time effect. At the final 12-month visit, the experimental/counseling group sustained a 51% decrease in children's exposure to cigarettes in the home from all smokers, while the monitoring control group showed an 18% decrease and the usual treatment control group a 15% decrease from pre-intervention [corrected].
Conclusion:
A behavioral medicine program was successful in reducing exposure to ETS in the home for these asthmatic children.