Fossum B, Arborelius E, Bremberg S
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Karolinska Hospital, Norrbacka, SE-171 76 Stockholm, Sweden.
Prev Med. 2004 Mar;38(3):295-301. doi: 10.1016/j.ypmed.2003.10.008.
Environmental tobacco smoke (ETS) is an important risk factor. The aim of this study is to evaluate effects of the counseling method "Smoke-free children" that focuses on protection of infants.
The counseling method, "Smoke-free children", has been developed and implemented at Swedish child health centers. The counseling method's point of departure is based upon a client-centered approach. Saliva cotinine samples from the mothers were collected when the child was 1-4 weeks and 3 months of age. Interviews regarding mothers' smoking habits and self-reported maternal smoking were also carried out.
Forty-one mothers participated in the study, 26 in the intervention group and 15 in the control group. Cotinine was collected from 22 subjects in the intervention and 8 in the control group. Before the intervention, the mean cotinine level was 185 ng/mL in the intervention group and 245 ng/mL in the control group. After the intervention, cotinine levels were reduced in the intervention group (165 ng/mL) and increased in the control group (346 ng/mL). Yet, after the intervention, the mothers themselves reported more smoking in the intervention group than in the control group. Only weak correlations were found between self-reported smoking and cotinine.
The statistical analysis supports the view that a client-centered intervention, aimed at increasing self-efficacy, exerts a positive effect on maternal smoking in the prevention of infant exposure to ETS, when applied in a routine clinical setting.
环境烟草烟雾（ETS）是一个重要的风险因素。本研究的目的是评估以保护婴儿为重点的“无烟儿童”咨询方法的效果。
“无烟儿童”咨询方法已在瑞典儿童健康中心开发并实施。该咨询方法的出发点是以客户为中心的方法。在孩子1 - 4周和3个月大时收集母亲的唾液可替宁样本。还进行了关于母亲吸烟习惯和自我报告的母亲吸烟情况的访谈。
41名母亲参与了研究，干预组26名，对照组15名。干预组22名受试者和对照组8名受试者收集了可替宁。干预前，干预组的平均可替宁水平为185 ng/mL，对照组为245 ng/mL。干预后，干预组的可替宁水平降低（165 ng/mL），对照组升高（346 ng/mL）。然而，干预后，干预组母亲自我报告的吸烟情况比对照组更多。自我报告的吸烟情况与可替宁之间仅发现微弱的相关性。
统计分析支持这样一种观点，即在常规临床环境中应用时，以客户为中心的干预旨在提高自我效能，对预防婴儿接触ETS时的母亲吸烟产生积极影响。
