PEDIATRICS Vol. 110 No. 5 November 2002, pp. 946-956
Asthma Management and Environmental Tobacco Smoke Exposure Reduction in Latino Children: A Controlled Trial
* Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California
Department of Psychology, San Diego State University, San Diego, California
Department of Political Science, San Diego State University, San Diego, California
|| Allergy and Asthma Medical Group and Research Center, San Diego, California
¶ Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention
--> Objectives. This study tested the efficacy of coaching to reduce environmental tobacco smoke (ETS) exposure among asthmatic Latino children.
Design. After asthma management education, families were randomly assigned to no additional service (control condition) or to coaching for ETS exposure reduction (experimental condition).
Setting. The study was conducted in San Diego, California.
Participants. Two hundred four Latino children (ages 3–17 years) with asthma participated.
Intervention. Approximately 1.5 hours of asthma management education was provided; experimental families also obtained 7 coaching sessions (
45 minutes each) to reduce ETS exposure.
Outcome Measures. Reported ETS exposure and children’s urine cotinine were measured.
Results. Parents in the coached condition reported their children exposed to significantly fewer cigarettes than parents of control children by 4 months (postcoaching). Reported prevalence of exposed children decreased to 52% for the coached families, but only to 69% for controls. By month 4, mean cotinine levels decreased among coached and increased among control children. Cotinine prevalence decreased from 54% to 40% among coached families, while it increased from 43% to 49% among controls. However, cotinine levels decreased among controls to the same level achieved by coached families by the 13-month follow-up.
Conclusions. Asthma management education plus coaching can reduce ETS exposure more than expected from education alone, and decreases in the coached condition may be sustained for about a year. The delayed decrease in cotinine among controls is discussed.
Key Words: environmental tobacco smoke • passive smoking • coaching • Latino • women • children • asthma • cotinine
Abbreviations: ETS, environmental tobacco smoke • TLFB, time-line follow back • GEE, generalized estimating equation
Received for publication Oct 23, 2001; Accepted May 21, 2002.
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