Skip to main content

Advertisement

SpringerLink
Log in

A Cluster Randomised Controlled Trial of a Brief Child Health Nurse Intervention to Reduce Infant Secondhand Smoke Exposure

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Background Exposure to secondhand smoke (SHS) is a significant contributor to ill health in children. A study was undertaken to determine the effectiveness of two brief multi-strategic child health nurse delivered interventions in: decreasing the prevalence of infants exposed to SHS; decreasing the prevalence of smoking amongst parent/carers of infants and increasing the prevalence of household smoking bans. Methods This study was a 3 arm, cluster randomised controlled trial. Clusters were 39 community based well child health clinics in one local area health service. Clinics were stratified according to annual number of client appointments and then randomly assigned in a 1:1:1 ratio, (Intervention 1: Intervention 2: Control), with 13 clinics in each cluster. Parents/carers of infants in the intervention groups received a brief multi-strategic intervention from child health nurses during clinic consultations. Treatment condition 1 included computer delivered risk assessment and feedback and nurse brief advice. Treatment condition 2 included all elements of Treatment condition 1 with the addition of biochemical feedback of infant SHS exposure. Results When compared to the Control group at 12 months, no significant differences in the prevalence of infant exposure to SHS were detected from baseline to follow-up for Treatment condition 1 (OR 1.16, 95 % CI 0.73–1.85, p = 0.53) or Treatment condition 2 (OR 1.30, 95 % CI 0.88–1.92, p = 0.19) Similarly, no significant differences were detected in the proportion of parent/carers who reported that they were smokers (T1:OR 0.95, 95 % CI 0.78–1.15, p = 0.58 and T2:OR 0.97, 95 % CI 0.80–1.18, p = 0.77), or in the proportion of households reported to have a complete smoking ban (T1:OR 1.21, 95 % CI 0.89–1.64, p = 0.23 and T2:OR 1.06, 95 % CI 0.79–1.43, p = 0.68). Conclusions Further research is required to identify effective interventions that can be consistently provided by child health nurses if the potential of such settings to contribute to reductions in child SHS exposure is to be realised.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Arditi, C., Rège-Walther, M., Wyatt, J., Durieux, P., & Burnand, B. (2012). Computer-generated reminders delivered on paper to healthcare professionals; effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews, (12), CD001175. doi:10.1002/14651858.CD001175.pub3.

  • Baxi, R., Sharma, M., Roseby, R., et al. (2014). Family and carer smoking control programmes for reducing children’s exposure to environmental tobacco smoke. The Cochrane Database of Systematic Reviews, 3, CD001746.

  • Benowitz, N. L. (1996). Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiologic Reviews, 18(2), 188–204.

    Article  CAS  PubMed  Google Scholar 

  • Borland, R., Yong, H.-H., Cummings, K. M., Hyland, A., Anderson, S., Fong, G. T. (2006). Determinants and consequences of smoke-free homes: findings from the International Tobacco Control (ITC) Four Country Survey. Tobacco Control, 15(suppl 3), iii42-iii50.

  • Carson, K. V., Verbiest, M. E., Crone, M. R., et al. (2012). Training health professionals in smoking cessation. Cochrane Database of Systematic Reviews, 5, CD000214.

  • Centre for Epidemiology and Evidence. (2012). 2009-2010 Summary Report from the New South Wales Child Health Survey. NSW Ministry of Health.

  • Centre for Epidemiology and Evidence. (2009). Summary Report on Adult Health from the New South Wales Population Health Survey. Sydney.

  • Committee on Environmental Health. (2009). Committee on Substance Abuse, Committee on Adolescence, Committee on Native American Child Health. Tobacco Use: A Pediatric Disease. Pediatrics, 124(5), 1474–1487.

    Google Scholar 

  • Curry, S. J., Keller, P. A., Orleans, C. T., & Fiore, M. C. (2008). The role of health care systems in increased tobacco cessation. Annual Review of Public Health, 29(1), 411–428.

    Article  PubMed  Google Scholar 

  • Daly, J., Wiggers, J., & Considine, R. (2001). Infant exposure to environmental tobacco smoke: A prevalence study in Australia. Australian and New Zealand Journal of Public Health, 25(2), 132–137.

    Article  CAS  PubMed  Google Scholar 

  • Dempsey, D. A., Meyers, M. J., Oh, S. S., et al. (2012). Determination of Tobacco Smoke Exposure by Plasma Cotinine Levels in Infants and Children Attending Urban Public Hospital Clinics. Archives of Pediatrics and Adolescent Medicine, 166(9), 851–856.

    Article  PubMed  PubMed Central  Google Scholar 

  • DiClemente, C. C., Marinilli, A. S., Singh, M., & Bellino, L. E. (2001). The role of feedback in the process of health behavior change. American Journal of Health Behavior, 25(3), 217–227.

    Article  CAS  PubMed  Google Scholar 

  • Fiore, M. C., Jaén, C. R., Baker, T. B., et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline.

  • Hughes, J., Keely, J., & Naud, S. (2004). Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction, 99(1), 29–38.

    Article  PubMed  Google Scholar 

  • Jepson, R. G., Harris, F. M., Platt, S., & Tannahill, C. (2010). The effectiveness of interventions to change six health behaviours: a review of reviews. BMC Public Health, 10(1), 1–16.

    Article  Google Scholar 

  • Johnson-Kozlow, M., Hovell, M. F., Rovniak, L. S., Sirikulvadhana, L., Wahlgren, D. R., Zakarian, J. M. (2008). Fidelity issues in secondhand smoking interventions for children. Nicotine & Tobacco Research, 10(12), 1677–1690.

  • Kallio, K., Jokinen, E., Hämäläinen, M., et al. (2006). Impact of repeated lifestyle counselling in an atherosclerosis prevention trial on parental smoking and children’s exposure to tobacco smoke. Acta Paediatrica, 95(3), 283–290.

    Article  PubMed  Google Scholar 

  • Kwok, M. K., Schooling, C. M., Ho, L. M., et al. (2008). Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong’s “Children of 1997” birth cohort. Tobacco Control, 17(4), 263–270.

  • Matt, G. E., Bernert, J. T., & Hovell, M. F. (2008). Measuring Secondhand Smoke Exposure in Children: An Ecological Measurement Approach. Journal of Pediatric Psychology, 33(2), 156–175.

    Article  PubMed  Google Scholar 

  • Matt, G., Wahlgren, D., Hovell, M., et al. (1999). Measuring environmental tobacco smoke exposure in infants and young children through urine cotinine and memory-based parental reports: empirical findings and discussion. Tobacco Control, 8(3), 282–289.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • NSW Department of Health. (2011). Child and Family Health Nursing: Professional Practice Framework 2011-2016. Sydney.

  • Öberg, M., Jaakkola, M. S., Woodward, A., Peruga, A., & Prüss-Ustün, A. (2011). Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. The Lancet, 377(9760), 139–146.

    Article  Google Scholar 

  • Orton, S., Jones, L. L., Cooper, S., Lewis, S., & Coleman, T. (2014). Predictors of children’s secondhand smoke exposure at home: a systematic review and narrative synthesis of the evidence. PLoS ONE, 9(11), e112690.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pojer, R., Whitfield, J. B., Poulos, V., Eckhard, I. F., Richmond, R., Hensley, W. J. (1984). Carboxyhemoglobin, cotinine, and thiocyanate assay compared for distinguishing smokers from non-smokers. Clinical Chemistry, 30(8), 1377–1380.

  • Rosen, L. J., Myers, V., Hovell, M., Zucker, D., & Ben Noach, M. (2014). Meta-analysis of parental protection of children from tobacco smoke exposure. Pediatrics, 133(4), 698–714.

    Article  PubMed  Google Scholar 

  • Rosen, L. J., Noach, M. B., Winickoff, J. P., & Hovell, M. F. (2012). Parental smoking cessation to protect young children: a systematic review and meta-analysis. Pediatrics, 129(1), 141–152.

    Article  PubMed  Google Scholar 

  • Royal College of Physicians. (2010). Passive smoking and children: A report of the Tobacco Advisory Group of the Royal College of Physicians. London.

  • SAS Institute Inc. (2001). SAS Software Version 9.3 for Windows [computer program]. Cary, NC: SAS Institute Inc.

  • Severson, H. H., Andrews, J. A., Lichtenstein, E., Wall, M., & Akers, L. (1997). Reducing maternal smoking and relapse: long-term evaluation of a pediatric intervention. Preventive Medicine, 26(1), 120–130.

    Article  CAS  PubMed  Google Scholar 

  • Stead, L., Hartmann-Boyce, J., Perera, R., Lancaster, T. (2013). Telephone counselling for smoking cessation. Cochrane Database of Systematic Reviews, (8), CD002850. doi:10.1002/14651858.CD002850.pub3.

  • Stead, L. F., Perera, R., Bullen, C., et al. (2012). Nicotine replacement therapy for smoking cessation. The Cochrane Database of Systematic Reviews, 11, CD000146.

  • US Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

  • Wakefield, M., Banham, D., McCaul, K., et al. (2002). Effect of feedback regarding urinary cotinine and brief tailored advice on home smoking restrictions among low-income parents of children with asthma: a controlled trial. Preventive Medicine, 34(1), 58–65.

    Article  PubMed  Google Scholar 

  • Winickoff, J. P., Nabi-Burza, E., Chang, Y., et al. (2014). Sustainability of a Parental Tobacco Control Intervention in Pediatric Practice. Pediatrics, 134(5), 933–941.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yılmaz, G., Karacan, C., Yöney, A., & Yılmaz, T. (2006). Brief intervention on maternal smoking: a randomized controlled trial. Child: Care, Health and Development, 32(1), 73–79.

    Google Scholar 

  • Zakarian, J. M., Hovell, M. F., Sandweiss, R. D., et al. (2004). Behavioral counseling for reducing children’s ETS exposure: implementation in community clinics. Nicotine & Tobacco Research, 6(6), 1061–1074.

Download references

Acknowledgments

We gratefully acknowledge the Project Advisory Group, consisting of members of Child and Family Health Nursing-Hunter New England Health, and The Centre for Health Research & Psycho-oncology (CHeRP). Also the child health nurses from participating clinics, the parent/carers and infants who participated in the study as well as Dr J Lynn Francis and Mr Christophe Lecathelinais for their support with the analysis.

Funding

This research was made possible by funding from The Financial Markets Foundation for Children, The Community Health and Anti Tuberculosis Association, The Centre for Health Research & Psycho-oncology (CHeRP) and with infrastructure support from the Hunter Medical Research Institute.

Author information

Authors and Affiliations

  1. Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2289, Australia

    Justine B. Daly, Megan Freund & John H. Wiggers

  2. Faculty of Health, School of Medicine and Population Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

    Justine B. Daly, Megan Freund, Robyn Considine & John H. Wiggers

  3. Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW, 2305, Australia

    Justine B. Daly, Megan Freund, Jennifer A. Bowman & John H. Wiggers

  4. Faculty of Science and Information Technology, School of Psychology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

    Jennifer A. Bowman

  5. School of Medicine and Pharmacology, University of Western Australia, 35 Sterling Highway, Crawley, 6009, Australia

    Sally Burrows

Authors
  1. Justine B. Daly
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Megan Freund
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sally Burrows
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robyn Considine
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jennifer A. Bowman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. John H. Wiggers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Justine B. Daly.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Daly, J.B., Freund, M., Burrows, S. et al. A Cluster Randomised Controlled Trial of a Brief Child Health Nurse Intervention to Reduce Infant Secondhand Smoke Exposure. Matern Child Health J 21, 108–117 (2017). https://doi.org/10.1007/s10995-016-2099-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-016-2099-5

Keywords

Search

Navigation