Find Established Evidence

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Telephone Support, Peer Counselor
Intervention Description: To examine whether telephone counselling based on the stages of change component of Transtheoretical model of behaviour change together with educational materials could help non-motivated smoking parents of young children to cease.
Conclusion: Proactive telephone counselling is an effective aid to promote smoking cessation among parents of young children.
Study Design: RCT
Setting: Community (maternal and child health centers)
Target Audience: Smoking mothers and fathers with young children aged 5 years
Data Source: 1997 Birth Cohort Study of the Department of Community Medicine, University of Hong Kong.
Sample Size: 952 families
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support, Educational Material, PROVIDER/PRACTICE, Community Health Workers (CHWs)
Intervention Description: To assess whether a theory-based, community health worker–delivered intervention for household smokers will lead to reduced secondhand smoke exposure to children in Chinese families.
Conclusion: The findings of this very first study in China showed that smoking hygiene intervention was effective in reducing children's exposure to secondhand smoke. These findings have implications for the development of primary health care–based secondhand smoke exposure reduction and family oriented smoking cessation interventions as China moves toward a smoke-free society.
Study Design: RCT
Setting: Community (households)
Target Audience: Smoking parents or caregivers who had a child aged 5 years or younger
Data Source: Health center records and parent selfreport.
Sample Size: 318 families
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Nurse/Nurse Practitioner
Intervention Description: To evaluate the efficacy of an early home-based intervention on the quality of maternal–infant attachment, maternal mood and child health parameters in a cohort of vulnerable families.
Conclusion: This form of early home based intervention targeted to vulnerable families promotes an environment conducive for infant mental and general health and hence long-term psychological and physical well-being, and is highly valued by the families who receive it.
Study Design: RCT
Setting: Community (child health nurse home visits)
Target Audience: Families with an infant and whose English literacy skills enabled them to complete a questionnaire
Data Source: Parent self-report and child’s personal health record book.
Sample Size: 181 families; Intervention (n=90), Control (n=91)
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Peer Counselor, Telephone Support
Intervention Description: The objective of this study was to assess whether counseling both mothers and fathers reduces their infants’ exposure to secondhand smoke (SHS).
Conclusion: Counseling similar to that employed in other countries can reduce infant exposure to SHS, suggesting generalizability.
Study Design: RCT
Setting: Recruited from health centers, intervention face-to-face and telephone
Target Audience: Nonsmoking children aged less than 1 year, exposed to their fathers’ or mothers’ smoking, and recruited from a health center in southern Tehran
Data Source: Parental self-report and infant urinary cotinine.
Sample Size: 130 children
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling
Intervention Description: Premature infants are at high risk for respiratory disease, and secondhand smoke (SHS) exposure further increases their risk for developing respiratory illness and asthma. Yet, SHS exposure remains problematic in this vulnerable population. Our objective was to evaluate the effects of brief asthma education plus motivational interviewing counseling on reducing SHS exposure and improving respiratory outcomes in premature infants compared to asthma education alone.
Conclusion: A community-based intervention incorporating motivational interviewing and asthma education may be helpful in reducing SHS exposure of premature infants in the short term. Further efforts are needed to support sustained protections for this high-risk group and ultimately, prevent acute and chronic respiratory morbidity. Strategies for successfully engaging families during this stressful period warrant attention.
Study Design: RCT
Setting: Community (home)
Target Audience: Pre-term infants and SHSe
Data Source: Golisano Children’s Hospital. Rochester, NY
Sample Size: 165 caregivers and their infants born at ≤ 32 weeks’ gestational age, within 6 weeks of discharge from the NICU
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Nicotine Replacement Therapy
Intervention Description: Secondhand smoke exposure is associated with asthma onset and exacerbation. Latino children have higher rates of asthma morbidity than other groups. The current study compared the effectiveness of a newly developed smoking cessation treatment with existing clinical guidelines for smoking cessation.
Conclusion: Results provide support for targeting specific populations with theory-based interventions.
Study Design: RCT
Setting: Hospital in-patient settings and clinics, and Latino cultural events
Target Audience: Latino caregivers who smoked and had a child with asthma under 18 years of age
Data Source: Parental self-report data, passive nicotine monitors.
Sample Size: 133 caregivers
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing
Intervention Description: We tested two aims: (1) the teachable moment (TM): whether second-hand smoke exposure (SHSe) feedback motivates cessation in parents of children with asthma versus parents of healthy children (HC); and (2) whether greater intervention intensity [enhanced-precaution adoption model (PAM)] produces greater cessation than a previously tested intervention (PAM).
Conclusion: Smoking cessation intervention (Motivational Interviewing plus biomarker feedback) appear to motivate smoking cessation more strongly among parents of asthmatic children than among parents of healthy children. Increased intervention intensity yields greater smoking cessation among parents of asthmatic children and better asthma outcomes.
Study Design: RCT
Setting: Community (home and telephone)
Target Audience: Parents of children with asthma and healthy children (ages 3-17 years)
Data Source: Parental self-report data, passive nicotine monitors.
Sample Size: 560 smoking primary caregivers of children with asthma and healthy children
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, COMMUNITY, Community Health Services Policy, Distribution of Promotional Items (Classroom/School), Distribution of Promotional Items (Community), Educational Material
Intervention Description: The intervention consists of three mailings and one brief coaching call delivered by 2-1-1 staff over 6 weeks. Emphasizes establishing a smoke-free home rather than smoking cessation.
Conclusion: Among those reached for 2-month follow-up, the proportion who reported establishing a smoke-free home was comparable to or higher than smoke-free home rates in the prior controlled research studies.
Study Design: RCTs; 1st was efficacy trial, 2nd was effectiveness trial, 3rd was a generalizability trial, [4th-5th not described in article]
Setting: Telephone counseling for an educational intervention
Target Audience: 5 2-1-1 centers chosen via competitive applications for a national grants program
Data Source: Participant reports; Tracking Tool for programs to record process of project
Sample Size: 2345 households at five 2-1-1 organizations
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Peer Counselor, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling
Intervention Description: To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker.
Conclusion: Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke.
Study Design: 3-arm RCT
Setting: Hospital and home
Target Audience: Inner-city children with asthma and SHSe
Data Source: Caregiver self-report, urine cotinine levels, and air nicotine concentrations
Sample Size: 126 children
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Motivational Interviewing, Motivational Interviewing/Counseling
Intervention Description: Intervention (INT) was a home-based asthma follow-up after ED visit and two visits for an environmental control educational program delivered by trained nurses and nurse practitioners to the child and caregiver. For caregivers of children with positive cotinine results, brief motivational interviewing sessions were conducted to implement total home smoking ban.
Conclusion: In this study, a home-based EC intervention was not successful in reducing asthma ED revisits in children with poorly controlled asthma with SHS exposure. Allergic sensitization, young age, and increased controller medication use were important predictors of asthma ED visits.
Study Design: Prospective randomized controlled trial
Setting: Home-based (following ED visit)
Target Audience: Children with physician diagnosed persistent asthma, having two or more ED asthma visits or more than one hospitalization over the past 12 months and residing in the Baltimore metropolitan area
Data Source: For SHS exposure, child saliva samples collected during the ED visit and at 6- and 12-month follow up visits.
Sample Size: 222 inner city children ages 3-12
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Motivational Interviewing/Counseling, PATIENT/CONSUMER, Motivational Interviewing, Educational Material, Nicotine Replacement Therapy, Educational Material (caregiver), Telephone Support
Intervention Description: In this randomized controlled trial, we tested a tobacco control intervention in families and specifically evaluated a tailored cessation intervention for the parents and/or caregivers (Ps/Cs) who were smokers while their children were simultaneously enrolled in tobacco prevention.
Conclusion: This study provides evidence that tailored cessation offered to Ps/Cs in their children’s schools during their children’s enrollment in tobacco prevention may contribute to more robust success in P/C cessation and a reduction of tobacco smoke exposure in children.
Study Design: 2-group RCT with repeated measures
Setting: Elementary school-based recruitment; Face-to-face or telephone motivational interviewing sessions
Target Audience: Elementary schools with high enrollment percentages of African American children in fourth grade across 5 counties in a Southeastern state
Data Source: Parent and caregiver self-report, biochemical measures (saliva cotinine and exhaled carbon monoxide)
Sample Size: 453 parents and or caregivers
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Motivational Interviewing, CAREGIVER, Motivational Interviewing/Counseling
Intervention Description: Individualized motivational intervention for 30 minutes with nurse counsellor; appropriate stage-matched intervention used to “increase motivation and lower resistance to quit”; telephone reminder 1 week after the intervention.
Conclusion: Preliminary results indicated that the IMI provided by nurses seemed to be effective in helping resistant parents of sick children stop smoking. They also suggested that it was acceptable and feasible to implement such intervention in a pediatric outpatient clinic/ward in Hong Kong.
Study Design: RCT
Setting: Hospital (pediatric ward/outpatient setting)
Target Audience: Parents of sick children who smoked
Data Source: Parental self-report
Sample Size: 80 parents of sick children presenting to a clinic or admitted to a children’s ward of a major Hong Kong hospital
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, CAREGIVER, Educational Material (caregiver)
Intervention Description: The aim of this study was to evaluate the effectiveness of a nursing educational intervention with mothers of sick children to decrease passive smoking exposure.
Conclusion: A simple health education intervention provided by nurses to the mothers in a busy clinical setting can be effective in the short-term to motivate the mothers to take actions to protect the children from exposure to passive smoking produced by the fathers.
Study Design: RCT
Setting: Hospital (pediatric ward/outpatient departments)
Target Audience: Non-smoking mothers of sick children admitted to the pediatric ward/smoking husbands living in the same household
Data Source: Parental self-report.
Sample Size: 1483 mothers of sick children
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Peer Counselor, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling
Intervention Description: The aim of the "Don't smoke in our home" trial was to evaluate a counseling intervention focused on promoting totally smoke-free homes and cars (TSFHC) delivered to women with children resident in four Tuscan towns.
Conclusion: Adding brief counseling to written materials did not significantly increase TSFHC. However, delivering written materials only may produce modest but noteworthy TSFHC increases at the population level, even though the participants in the study did not represent a population-based sample, given the high proportion of highly educated women. Further studies are required to confirm these results.
Study Design: Two-group randomized controlled trial
Setting: Pediatric well visit
Target Audience: Children exposed to SHS
Data Source: The trial staff recruited women aged 30-49 years with children in the waiting rooms of public health facilities, hospitals and outside of supermarkets
Sample Size: 218 women 30 to 49 years of age with children
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Group Education, Telephone Support, Educational Material, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver)
Intervention Description: This study examined the effects of a parent–child interactive program on reducing children’s exposure to ETS at home and enhancing parents’ and children’s prevention strategies.
Conclusion: This is a preliminary study design aimed at creating a program for reducing children’s ETS exposure at home. Further research to produce evidence supporting the application of the parent–child interactive program in primary schools is suggested. The theoretical basis of the intervention design can serve as a reference for nursing education and the design of health education programs.
Study Design: Single-blind, two-group, repeated-measures clustered randomized controlled trial design
Setting: Community (schools)
Target Audience: School-aged children’s reduction of SHSe
Data Source: Elementary schools were the unit of assignment
Sample Size: 75 parent and child dyads in 6 elementary schools (grades 3 to 6)
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, CAREGIVER, Educational Material (caregiver)
Intervention Description: To test a low-intensity physician's office-based intervention strategy using infant urine cotinine measurements, aimed at reducing infant exposure to environmental tobacco smoke.
Conclusion: The low-intensity intervention strategy did not significantly influence infant exposure to environmental tobacco smoke in the household.
Study Design: RCT
Setting: Pediatric well visit
Target Audience: Infants exposed to second hand smoke
Data Source: Two hospital-based clinics in Portland Maine.
Sample Size: 103 mothers smoking ≥ 10 cigarettes/d with infants presenting to a well-baby check
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Intensive Therapy, CAREGIVER, Motivational Interviewing/Counseling
Intervention Description: We tested the efficacy of a behavioral counseling approach with underserved maternal smokers to reduce infant’s and preschooler’s secondhand smoke exposure.
Conclusion: FRESH behavioral counseling reduces child secondhand smoke exposure and promotes smoking quit rates in a highly distressed and vulnerable population.
Study Design: Two-arm randomized trial
Setting: Community (home and telephone)
Target Audience: Underserved children’s exposure to tobacco smoke
Data Source: Participants were recruited from lowincome neighborhoods in North and West Philadelphia
Sample Size: 300 families
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, HOSPITAL, Continuing Education of Hospital Providers, Policy/Guideline (Hospital), Educational Material (Provider), Guideline Change and Implementation
Intervention Description: We hypothesized that a pragmatic, multilevel treatment model including (ask, advise, refer [AAR]) coupled with individualized, telephone-based behavioral counseling promoting child tobacco smoke exposure (TSE) reduction would demonstrate greater child TSE reduction than would standard AAR.
Conclusion: The results indicate that the integration of clinic- and individual-level smoking interventions produces improved TSE and cessation outcomes relative to standalone clinic AAR intervention. Moreover, this study was among the first in which researchers demonstrated success in embedding AAR decision aids into electronic health records and seamlessly facilitated TSE intervention into routine clinic practice.
Study Design: RCT
Setting: Community (home)
Target Audience: Tobacco-smoking parents living in low-income, urban communities with children <11 years old exposed daily to tobacco smoke in the home. Additional inclusion criteria: daily smoker, >17 years old, and speaking English
Data Source: Structured telephone interviews for baseline data collection and 3-month follow-up.
Sample Size: 334 providers. 327 participants (n=163 AAR and counseling, n=164 AAR and control)
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), Outreach (Provider), PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Home Visits
Intervention Description: To evaluate the effectiveness of a lay delivered intervention to reduce Latino children’s exposure to environmental tobacco smoke (ETS). The a priori hypothesis was that children living in households that were in the intervention group would have lower exposure over time than measurement only controls.
Conclusion: Applying a lay promotora model to deliver the behavioural problem solving intervention unfortunately was not effective. A likely explanation relates to the difficulty of delivering a relatively complex intervention by lay women untrained in behaviour change theory and research methods.
Study Design: Two group, randomized control trial
Setting: Community (home)
Target Audience: Latino children
Data Source: Recruited from community organizations and venues such as Head Start Programs and cultural fairs
Sample Size: 143 Latino parents of children aged 1 to 9 who reported smoking at least 6 cigarettes a week
Age Range: Not specified

NPM: 14-2: Smoking in the Household
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Nicotine Replacement Therapy
Intervention Description: Nicotine replacement therapy (NRT) is effective for cessation outside pregnancy but efficacy and safety in pregnancy are unknown. We hypothesised that NRT would increase smoking cessation in pregnancy without adversely affecting infants.
Conclusion: Nicotine replacement therapy patches had no enduring, significant effect on smoking in pregnancy; however, 2-year-olds born to women who used NRT were more likely to have survived without any developmental impairment. Further studies should investigate the clinical effectiveness and safety of higher doses of NRT.
Study Design: Double-blind, randomized, placebo-controlled trial
Setting: Community (antenatal clinic)
Target Audience: Pregnant women who smoked
Data Source: Caregiver self-reported, prolonged abstinence from smoking between a quit date and childbirth, validated at delivery by CO measurement and/or salivary cotinine (COT).
Sample Size: 1050 smoking 12- to 24-week pregnant women who currently smoke 5 or more cigarettes/d who smoked at least 10 cigarettes/d before pregnancy
Age Range: Not specified