Tyc Vida L, Huang Qinlei, Nicholson Jody, Schultz Bethany, Hovell Melbourne F, Lensing Shelly, Vukadinovich Chris, Hudson Melissa M, Zhang Hui
Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Psychooncology. 2013 May;22(5):1104-11. doi: 10.1002/pon.3117. Epub 2012 Jun 8.
This randomized controlled trial tested the efficacy of parent-based behavioral counseling for reducing secondhand smoke exposure (SHSe) among children with cancer. It also examined predictors of smoking and SHSe outcomes.
Participants were 135 parents or guardians of nonsmoking children with cancer, <18 years, at least 30 days postdiagnosis, and living with at least one adult smoker. Parents were randomized to either a standard care control group or an intervention consisting of six counseling sessions delivered over 3 months. Parent-reported smoking and child SHSe levels were obtained at baseline, 3, 6, 9, and 12 months. Children provided urine samples for cotinine analyses.
Reductions in parent-reported smoking and exposure were observed in both the intervention and control conditions. There was a significantly greater reduction in parent-reported smoking and child SHSe at 3 months for the intervention group compared with the control group. Child SHSe was significantly lower at 12 months relative to baseline in both groups. Children's cotinine levels did not show significant change over time in either group. Exposure outcomes were influenced by the number of smokers at home, smoking status of the parent participating in the trial, and the child's environment (home versus hospital) the day before the assessment.
Children's SHSe can be reduced by advising parents to protect their child from SHSe, combined with routine reporting of their child's exposure and cotinine testing, when delivered in the context of the pediatric cancer setting. More intensive interventions may be required to achieve greater reductions in SHSe.
这项随机对照试验测试了以家长为基础的行为咨询对减少癌症患儿二手烟暴露（SHSe）的效果。它还研究了吸烟及二手烟暴露结果的预测因素。
参与者为135名18岁以下癌症非吸烟患儿的家长或监护人，诊断后至少30天，且与至少一名成年吸烟者同住。家长被随机分为标准护理对照组或干预组，干预组包括在3个月内进行的6次咨询课程。在基线、3个月、6个月、9个月和12个月时获取家长报告的吸烟情况及儿童二手烟暴露水平。儿童提供尿液样本进行可替宁分析。
在干预组和对照组中均观察到家长报告的吸烟及暴露情况有所减少。与对照组相比，干预组在3个月时家长报告的吸烟及儿童二手烟暴露减少更为显著。两组在12个月时儿童二手烟暴露相对于基线均显著降低。两组儿童的可替宁水平随时间均未显示出显著变化。暴露结果受家中吸烟者数量、参与试验的家长吸烟状况以及评估前一天儿童所处环境（家中还是医院）的影响。
在儿科癌症环境中，通过建议家长保护孩子免受二手烟暴露，并结合定期报告孩子的暴露情况及进行可替宁检测，可以减少儿童的二手烟暴露。可能需要更强化的干预措施来实现更大程度的二手烟暴露减少。
