Chellini Elisabetta, Gorini Giuseppe, Carreras Giulia
Environmental and Occupational Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy.
Tumori. 2013 Jan-Feb;99(1):23-9. doi: 10.1177/030089161309900104.
Increasing smoke-free homes is an important public health goal, but only few interventions have yielded positive results. 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.
We used a two-group randomized controlled trial design. Participants were asked about their smoking habits and about restrictions on smoking in their homes and cars. All women received a self-help booklet promoting TSFHC, and 110 women randomized to the intervention also attended brief counseling on second-hand smoke exposure protection and received three gifts to remember the commitment to TSFHC. Follow-up was conducted by phone after four months.
We recruited 218 women, 64 of whom had a university degree and 131 of whom were smokers; 62% reported smoking indoors and 58% in cars. Before the intervention, nonsmokers were more likely to report totally smoke-free homes (TSFH, 52%) and cars (TSFC, 53%) than smokers (26% and 17% respectively; P <0.001). Participants of the experimental arm had similar odds as controls of having implemented TSFH after the intervention, and nonsignificantly increased odds of having introduced TSFC (odds ratio [OR] 1.47; 95% confidence interval [CI] 0.69-3.11), particularly among smokers (OR 2.24, 95%CI 0.69-7.26). All participants independently of the study arm recorded significant increases of 12 and 15 percentage points in TSFH and TSFC, respectively. Few smokers quit smoking (7%), stopped smoking indoors (5%), and stopped smoking in cars (7%), with no differences between the intervention and control groups.
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.
增加无烟家庭数量是一项重要的公共卫生目标，但仅有少数干预措施取得了积极成果。“请勿在我们家中吸烟”试验的目的是评估一项针对居住在托斯卡纳四个城镇且育有子女的女性开展的咨询干预措施，该措施着重推广家庭和汽车完全无烟（TSFHC）。
我们采用了两组随机对照试验设计。询问了参与者的吸烟习惯以及家庭和汽车内的吸烟限制情况。所有女性都收到了一本宣传TSFHC的自助手册，随机分配到干预组的110名女性还参加了关于二手烟暴露防护的简短咨询，并收到三件礼物以铭记对TSFHC的承诺。四个月后通过电话进行随访。
我们招募了218名女性，其中64人拥有大学学位，131人吸烟；62%的人报告在室内吸烟，58%的人在汽车内吸烟。干预前，非吸烟者比吸烟者更有可能报告家庭（TSFH，52%）和汽车（TSFC，53%）完全无烟（吸烟者分别为26%和17%；P<0.001）。干预后，试验组参与者实现TSFH的几率与对照组相似，引入TSFC的几率虽有增加但不显著（优势比[OR]1.47；95%置信区间[CI]0.69 - 3.11），在吸烟者中尤其如此（OR 2.24，95%CI 0.69 - 7.26）。所有参与者，无论所属研究组，TSFH和TSFC分别显著增加了12和15个百分点。很少有吸烟者戒烟（7%）、停止在室内吸烟（5%）以及停止在汽车内吸烟（7%），干预组和对照组之间无差异。
在书面材料基础上增加简短咨询并未显著增加TSFHC。然而，即便研究中的参与者并非基于人群的样本（鉴于高学历女性比例较高），仅提供书面材料可能在人群层面使TSFHC有适度但值得注意的增加。需要进一步研究来证实这些结果。
