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PEDIATRICS Vol. 108 No. 1 July 2001, pp. 18-24
Received Jul 14, 2000; accepted Nov 2, 2000.
,
From the * Dana-Farber Cancer Institute and Harvard School of
Public Health, Boston, Massachusetts; Objective. Passive smoke
exposure among children is widespread in the United States;
estimates suggest that almost 40% of children who are younger than 5 years live with a smoker. Few randomized studies of passive smoke
exposure reduction among children have been conducted, and the impact
of interventions that have been evaluated has been limited. The
objective of this study was to determine whether a motivational
intervention for smoking parents of young children will lead to reduced
household passive smoke exposure.
Methods. Project KISS (Keeping Infants Safe From Smoke), a
theory-driven exposure reduction intervention targeting low-income
families with young children, was a randomized controlled study in
which participants Results. The 6-month nicotine levels were significantly
lower in MI households. Repeated measures analysis of variance across
baseline, 3-month, and 6-month time points showed a significant
time-by-treatment interaction, whereby nicotine levels for the MI group
decreased significantly and nicotine levels for the SH group increased
but were not significantly different from baseline.
Conclusions. This study targeted a large sample of
racially and ethnically diverse low-income families, in whom both
exposure and disease burden is likely to be significant. This is the
first study to our knowledge that has been effective in reducing
objective measures of passive smoke exposure in households with healthy
children. These findings have important implications for pediatric
health care providers, who play an important role in working with
parents to protect children's health. Providers can help parents work toward reducing household passive smoke exposure using motivational strategies and providing a menu of approaches regardless of whether the
parents are ready to quit.
University of California at
Berkeley, Berkeley, California; § University of Rhode Island, Kingston,
Rhode Island; and Brown University School of Medicine, Providence,
Rhode Island.
smoking parents/caregivers (N = 291) who had children who were younger than 3 years and who were
recruited through primary care settingswere randomly assigned to
either the motivational intervention (MI) or a self-help (SH)
comparison condition was used. Follow-up assessments were conducted at
3 and 6 months. The MI condition consisted of a 30- to 45-minute
motivational interviewing session at the participant's home with a
trained health educator and 4 follow-up telephone counseling calls.
Feedback from baseline household air nicotine assessments and
assessment of the participant's carbon monoxide level was provided as
part of the intervention. Participants in the SH group received a copy of the smoking cessation manual, the passive smoke reduction tip sheet,
and the resource guide in the mail. Household nicotine levels were
measured by a passive diffusion monitor.
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