Changing Exposure Perceptions: A Randomized Controlled Trial of an Intervention with Smoking Parents

Vicki Myers, Shoshana Shiloh, David M Zucker, Laura J Rosen, Vicki Myers, Shoshana Shiloh, David M Zucker, Laura J Rosen

Abstract

Children who live with smokers are at risk of poor health, and of becoming smokers themselves. Misperceptions of the nature of tobacco smoke exposure have been demonstrated among parents, resulting in continued smoking in their children's environment. This study aimed to change parents' perceptions of exposure by providing information on second- and third-hand exposure and personalised information on children's exposure [NIH registry (NCT02867241)]. One hundred and fifty-nine families with a child < 8 years and at least one smoking parent were randomized into intervention (69), control (70), and enhanced control (20) groups. Reported exposure, parental smoking details, and a child hair sample were obtained at the start of the study and 6-8 months later. Parental perceptions of exposure (PPE) were assessed via a questionnaire. The intervention consisted of motivational interviews, feedback of home air quality and child's hair nicotine level, and information brochures. PPE were significantly higher at the study end (94.6 ± 17.6) compared to study beginning (86.5 ± 19.3) in intervention and enhanced control groups (t(72) = -3.950; p < 0.001). PPE at study end were significantly higher in the intervention group compared to the regular control group (p = 0.020). There was no significant interaction between time and group. Parallel changes in parental smoking behaviour were found. Parental perceptions of exposure were increased significantly post intervention, indicating that they can be altered. By making parents more aware of exposure and the circumstances in which it occurs, we can help parents change their smoking behaviour and better protect their children.

Keywords: RCT; children; intervention; motivational interviewing; parental smoking; perceptions; secondhand smoke; tobacco smoke exposure.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study protocol by group.
Figure 2
Figure 2
PPE over time across study groups. * denominates significant difference (p < 0.05) between T1 and T2. ** denominates significant difference (p < 0.05) between intervention and regular control at T2. Error bars show standard deviation.

References

    1. Department of Health and Human Services . The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Centers for Disease Control and Prevention Office on Smoking and Health; Atlanta, GA, USA: 2006.
    1. Raghuveer G., White D.A., Hayman L.L., Woo J.G., Villafane J., Celermajer D., Ward K.D., de Ferranti S.D., Zachariah J. Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure: Prevailing Evidence, Burden, and Racial and Socioeconomic Disparities A Scientific Statement From the American Heart Association. Circulation. 2016;134:e336–e359. doi: 10.1161/CIR.0000000000000443.
    1. Oberg M., Jaakkola M.S., Woodward A., Peruga A., Pruss-Ustun A. Worldwide burden of disease from exposure to second-hand smoke: A retrospective analysis of data from 192 countries. Lancet. 2011;377:139–146. doi: 10.1016/S0140-6736(10)61388-8.
    1. Leonardi-Bee J., Jere M.L., Britton J. Exposure to parental and sibling smoking and the risk of smoking uptake in childhood and adolescence: A systematic review and meta-analysis. Thorax. 2011;66:847–855. doi: 10.1136/thx.2010.153379.
    1. Rosen L.J., Lev E., Guttman N., Tillinger E., Rosenblat S., Zucker D.M., Myers V. Parental perceptions and misconceptions of child tobacco smoke exposure. Nicotine Tob. Res. 2018;20:1369–1377. doi: 10.1093/ntr/ntx169.
    1. Kegler M.C., Haardörfer R., Bundy L.T., Escoffery C., Berg C.J., Fernandez M., Williams R., Hovell M. Do partial home smoking bans signal progress toward a smoke-free home? Health Educ. Res. 2016;31:24–35. doi: 10.1093/her/cyv066.
    1. Johansson A.K., Hermansson G., Ludvigsson J. How Should Parents Protect Their Children From Environmental Tobacco-Smoke Exposure in the Home? Pediatrics. 2004;113:e291–e295. doi: 10.1542/peds.113.4.e291.
    1. Spencer N., Blackburn C., Bonas S., Coe C., Dolan A. Parent reported home smoking bans and toddler (18–30 month) smoke exposure: A cross-sectional survey. Arch. Dis. Child. 2005;90:670–674. doi: 10.1136/adc.2004.054684.
    1. Hovell M., Zakarian J., Matt G.E., Liles S., Jones J.A., Hofstetter C.R., Larson S.N., Benowitz N.L. Counseling to reduce children’s secondhand smoke exposure and help parents quit smoking: A controlled trial. Nicotine Tob. Res. 2009;11:1383–1394. doi: 10.1093/ntr/ntp148.
    1. Irvine L., Crombie I.K., Clark R.A., Slane P.W., Feyerabend C., Goodman K.E., Cater J.I. Advising parents of asthmatic children on passive smoking: Randomised controlled trial. Br. Med. J. 1999;318:1456–1459. doi: 10.1136/bmj.318.7196.1456.
    1. Wilson S.R., Farber H.J., Knowles S.B., Lavori P.W. A randomized trial of parental behavioral counseling and cotinine feedback for lowering environmental tobacco smoke exposure in children with asthma: Results of the LET’S Manage Asthma trial. Chest. 2011;139:581–590. doi: 10.1378/chest.10-0772.
    1. Fossum B., Arborelius E., Bremberg S. Evaluation of a counseling method for the prevention of child exposure to tobacco smoke: An example of client-centered communication. Prev. Med. 2004;38:295–301. doi: 10.1016/j.ypmed.2003.10.008.
    1. Yilmaz G., Karacan C., Yoney A., Yilmaz T. Brief intervention on maternal smoking: A randomized controlled trial. Child Care Health Dev. 2006;32:73–79. doi: 10.1111/j.1365-2214.2006.00570.x.
    1. Zakarian J.M., Hovell M.F., Sandweiss R.D., Hofstetter C.R., Matt G.E., Bernert J.T., Pirkle J., Hammond S.K. Behavioral counseling for reducing children’s ETS exposure: Implementation in community clinics. Nicotine Tob. Res. 2004;6:1061–1074. doi: 10.1080/1462220412331324820.
    1. McIntosh N.A., Clark N.M., Howatt W.F. Reducing tobacco smoke in the environment of the child with asthma: A cotinine-assisted, minimal-contact intervention. J. Asthma. 1994;31:453–462. doi: 10.3109/02770909409089487.
    1. Hovell M.F., Meltzer S.B., Wahlgren D.R., Matt G.E., Hofstetter C.R., Jones J.A., Meltzer E.O., Bernert J.T., Pirkle J.L. Asthma management and environmental tobacco smoke exposure reduction in Latino children: A controlled trial. Pediatrics. 2002;110:946–956. doi: 10.1542/peds.110.5.946.
    1. Baxi R., Sharma M., Roseby R., Baxi R., Webster P. Family and carer smoking control programmes for reducing children’s exposure to environmental tobacco smoke. Cochrane Database Syst. Rev. 2014;1:CD001746. doi: 10.1002/14651858.CD001746.pub3.
    1. Rosen L.J., Myers V., Hovell M., Zucker D., Ben Noach M. Meta-analysis of parental protection of children from tobacco smoke exposure. Pediatrics. 2014;133:698–714. doi: 10.1542/peds.2013-0958.
    1. Myers V., Shiloh S., Rosen L.J. Parental perceptions of children’s exposure to tobacco smoke: Development and validation of a new measure. BMC Public Health. 2018;18:1031. doi: 10.1186/s12889-018-5928-1.
    1. Myers V., Zucker D., Rosen L.J., Shiloh S. Parental perceptions of children’s exposure to tobacco smoke and parental smoking behaviour. Int. J. Environ. Res. Public Health. 2020;17
    1. Godin G., Sheeran P., Conner M., Delage G., Germain M., Bélanger-Gravel A., Naccache H. Which survey questions change behavior? Randomized controlled trial of mere measurement interventions. Health Psychol. 2010;29:636–644. doi: 10.1037/a0021131.
    1. Petrie K.J., Weinman J. Patients’ Perceptions of Their Illness: The Dynamo of Volition in Health Care. Curr. Dir. Psychol. Sci. 2012;21:60–65. doi: 10.1177/0963721411429456.
    1. McCambridge J. From question-behaviour effects in trials to the social psychology of research participation. Psychol. Health. 2015;30:72–84. doi: 10.1080/08870446.2014.953527.
    1. Rodrigues A.M., O’Brien L., French D.P., Glidewell L., Sniehotta F.F. The Question–Behavior Effect: Genuine Effect or Spurious Phenomenon? A Systematic Review of Randomized Controlled Trials with Meta-Analyses. Health Psychol. 2015;34:61–78. doi: 10.1037/hea0000104.
    1. Chandon P., Morwitz V.G., Reinartz W.J. Do Intentions Really Predict Behavior? Self-Generated Validity Effects in Survey Research. J. Market. 2005;69:1–14. doi: 10.1509/jmkg.69.2.1.60755.
    1. French D.P., Sutton S. Reactivity of measurement in health psychology: How much of a problem is it? What can be done about it? Br. J. Health Psychol. 2010;15:453–468. doi: 10.1348/135910710X492341.
    1. Morwitz V.G., Johnson E., Schmittlein D. Does Measuring Intent Change Behavior? J. Consum. Res. 1993;20:46–61. doi: 10.1086/209332.
    1. Morwitz V.G., Fitzsimons G.J. The Mere-Measurement Effect: Why Does Measuring Intentions Change Actual Behavior? J. Consum. Psychol. 2004;14:64–74. doi: 10.1086/20933210.1207/s15327663jcp1401&2_8.
    1. Abdullah A.S., Mak Y.W., Loke A.Y., Lam T.H. Smoking cessation intervention in parents of young children: A randomised controlled trial. Addiction. 2005;100:1731–1740. doi: 10.1111/j.1360-0443.2005.01231.x.
    1. Eriksen W., Sorum K., Bruusgaard D. Effects of information on smoking behaviour in families with preschool children. Acta Pediatr. 1996;85:209–212. doi: 10.1111/j.1651-2227.1996.tb13994.x.
    1. Petrie K.J., Cameron L.D., Ellis C.J., Buick D., Weiman J. Changing Illness Perceptions After Myocardial Infarction: An Early Intervention Randomized Controlled Trial. Psychosom. Med. 2002;64:580–586. doi: 10.1097/00006842-200207000-00007.
    1. Siemonsma P.C., Stuive I., Roorda L.D., Vollebregt J.A., Walker M.F., Lankhorst G.J., Lettinga A.T. Cognitive treatment of illness perceptions in patients with chronic low back pain: A randomized controlled trial. Phys. Ther. 2013;93:435–448. doi: 10.2522/ptj.20110150.
    1. Meyer D., Leventhal H., Gutmann M. Common-sense models of illness: The example of hypertension. Health Psychol. 1985;4:115–135. doi: 10.1037/0278-6133.4.2.115.
    1. Conrad P. Who comes to work-site wellness programs? A preliminary review. J. Occup. Med. 1987;29:317–320.

Source: PubMed

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