Reduction of Environmental Tobacco Smoke Exposure Among Asthmatic Children: A Controlled Trial

Hovell, Melbourne F.; Meltzer, Susan B.; Zakarian, Joy M.; Wahlgren, Dennis R.; Emerson, Jennifer A.; Hofstetter, C. Richard; Leaderer, Brian P.; Meltzer, Eli O.; Zeiger, Robert S.; O’Connor, Richard D.; Mulvihill, Mary M.; Atkins, Catherine J.

doi:10.1378/chest.106.2.440

Cited by 120 publications

(81 citation statements)

References 15 publications

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“…Such trials are important in the context of the studies successfully completed in the last 20 years showing that SHS exposure can be reduced when families are coached to do so (Hovell et al, 1994(Hovell et al, , 2000(Hovell et al, , 2002(Hovell et al, , 2009Klepeis et al, 2013;Meltzer, Hovell, Meltzer, Atkins, & de Peyster, 1993).…”

Section: Continuedmentioning

confidence: 99%

Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

Daffa

Liles

Jackson

et al. 2014

Nicotine &Amp; Tobacco Research

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We examined homes of hookah-only smokers and nonsmokers for levels of indoor air nicotine (a marker of secondhand smoke) and indoor surface nicotine (a marker of thirdhand smoke), child uptake of nicotine, the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and the toxicant acrolein by analyzing their corresponding metabolites cotinine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and NNAL-glucuronides (total NNAL) and 3-hydroxypropylmercapturic acid.

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Section: Continuedmentioning

confidence: 99%

Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

Daffa

Liles

Jackson

et al. 2014

Nicotine &Amp; Tobacco Research

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“…13,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] The trials were conducted in the United States, China, Norway, Scotland, Finland, Italy, and Australia between 1987 and 2010. Forty-seven studies were excluded for the following reasons: quit rates were not reported or were not reported separately for intervention and control groups, or numbers of participants were not reported (24 studies ; the study design was not a controlled trial [11 studies [59][60][61][62][63][64][65][66][67][68][69] ]), the interventions were not aimed at parents of young children (9 studies [70][71][72][73][74][75][76][77][78] ); the reporting period was less than 1 month (1 study 79 ); a protocol only was reported (1 study 80 ); the report was not in English (1 study 81 ). The flowchart describing the identification process can be found in Fig 1. Study characteristics of included trials are presented in Table 1.…”

Section: Description Of Studiesmentioning

confidence: 99%

Parental Smoking Cessation to Protect Young Children:A Systematic Review and Meta-analysis

et al. 2012

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BACKGROUND: Young children can be protected from much of the harm from tobacco smoke exposure if their parents quit smoking. Some researchers encourage parents to quit for their children's benefit, but the evidence for effectiveness of such approaches is mixed. OBJECTIVE: To perform a systematic review and meta-analysis to quantify the effects of interventions that encourage parental cessation. METHODS: We searched PubMed, the Cochrane Library, Web of Science, and PsycINFO. Controlled trials published before April 2011 that targeted smoking parents of infants or young children, encouraged parents to quit smoking for their children's benefit, and measured parental quit rates were included. Study quality was assessed. Relative risks and risk differences were calculated by using the DerSimonian and Laird random-effects model. RESULTS: Eighteen trials were included. Interventions took place in hospitals, pediatric clinical settings, well-baby clinics, and family homes. Quit rates averaged 23.1% in the intervention group and 18.4% in the control group. The interventions successfully increased the parental quit rate. Subgroups with significant intervention benefits were children aged 4 to 17 years, interventions whose primary goal was cessation, interventions that offered medications, and interventions with high follow-up rates (>80%). CONCLUSIONS: Interventions to achieve cessation among parents, for the sake of the children, provide a worthwhile addition to the arsenal of cessation approaches, and can help protect vulnerable children from harm due to tobacco smoke exposure. However, most parents do not quit, and additional strategies to protect children are needed.

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“…[12][13][14][15][16][17][18][19][20][21][22][23] Only from 1 of those studies was a sustained reduction in exposure to environmental tobacco smoke, measured as cotinine levels, reported, and from another study a significant reduction in the number of unscheduled asthma visits was reported. 12,13 Collectively, these trials raise serious questions about whether it is prudent to continue to rely on anticipatory guidance to reduce children's exposure to tobacco smoke.…”

Section: Discussionmentioning

confidence: 99%

“…11 Numerous studies have tested the efficacy of anticipatory guidance to reduce SHS exposure for children, but the majority failed to show significant reductions in children's SHS exposure by using measurements of cotinine, a metabolite of nicotine, or improvements in asthma symptoms. [12][13][14][15][16][17][18][19][20][21][22][23] This problem might be overcome if there was a technology to reduce SHS exposure passively, such as highefficiency, particulate-arresting (HEPA) air cleaners.…”

mentioning

confidence: 99%

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

2010

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Exposure to secondhand smoke (SHS) is associated with asthma exacerbations in children. Anticipatory guidance has failed to reduce SHS in controlled trials. It is not known whether high-efficiency, particlearresting (HEPA) air cleaners can reduce SHS or improve asthma symptoms in children. WHAT THIS STUDY ADDS:HEPA air cleaners led to reductions in unscheduled asthma visits and fine airborne particle levels but not asthma symptoms or cotinine levels. HEPA air cleaners may be useful as part of a multifaceted strategy to reduce asthma morbidity among children. abstract OBJECTIVE:The goal was to test the effects of high-efficiency, particulatearresting (HEPA) air cleaners on unscheduled asthma visits and symptoms among children with asthma exposed to secondhand smoke. METHODS:We enrolled 225 eligible children who were 6 to 12 years of age, had physician-diagnosed asthma, and were exposed to Ն5 cigarettes per day. We conducted a double-blind, randomized trial. Children were assigned randomly to receive 2 active or inactive HEPA air cleaners. RESULTS:Of 225 enrolled children, 110 (49%) were assigned to the intervention group and 115 (51%) to the control group; 215 (95%) completed the trial. During the trial, there were 42 fewer unscheduled asthma visits among children in the intervention group (18.5% [95% confidence interval: 1.25%-82.75%]; P ϭ .043), compared with those in the control group, after adjustment for baseline differences. There was a significant difference in the reductions of levels of particles of Ͼ0.3 m according to group assignment; there was a 25% reduction in particle levels in the intervention group, compared with a 5% reduction in the control group (P ϭ .026). There were no significant differences in parent-reported asthma symptoms, exhaled nitric-oxide levels, air nicotine levels, or cotinine levels according to group assignment. CONCLUSIONS:These results hold promise for using HEPA air cleaners as part of a multifaceted strategy to reduce asthma morbidity, but further research is necessary before they can be recommended routinely for the medical management of asthma.

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Reduction of Environmental Tobacco Smoke Exposure Among Asthmatic Children: A Controlled Trial

Cited by 120 publications

References 15 publications

Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

Parental Smoking Cessation to Protect Young Children:A Systematic Review and Meta-analysis

Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke

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