Huque Rumana, Dogar Omara, Cameron Ian, Thomson Heather, Amos Amanda, Siddiqi Kamran
Department of Economics, University of Dhaka, Dhaka, Bangladesh;
Department of Health Sciences, University of York, York, UK;
Nicotine Tob Res. 2015 Dec;17(12):1465-72. doi: 10.1093/ntr/ntv015. Epub 2015 Jan 29.
Exposure to second-hand smoke is a threat to children's health. We developed a school-based smoke-free intervention (SFI) to support families in implementing smoke-free homes in Bangladesh, and gathered preliminary evidence of its effectiveness.
A feasibility cluster randomized controlled trial of SFI was conducted in 24 schools in Mirpur, an urban area within Dhaka. Using simple stratified randomization, schools were allocated to: Arm A (SFI only), Arm B (SFI plus reminders), and Arm C (the control group). A total of 781 year-5 children (10-12 years old) in the consenting schools, participated in the study. Outcomes including "smoke-free homes" and "social visibility" that is, not smoking in front of children at home were assessed through questionnaire-based children's surveys, administered by researchers, at baseline and at weeks 1, 12, 27, and 52 in all arms.
"Smoke-free homes" were significantly higher in Arm A (odds ratio [OR] = 4.8; 95% CI = 2.6-9.0) and in Arm B (OR = 3.9; 95% CI = 2.0-7.5) than in Arm C, when controlled for the baseline levels, at year 1. Similarly, "social visibility" was significantly reduced in Arm A (OR = 5.8; 95% CI = 2.8-11.7) and in Arm B (OR = 7.2; 95% CI = 3.3-15.9) than Arm C, when controlled for the baseline levels, at year 1. We observed an increasing trend (Cochrane Armitage test statistic [Z] = 3.8; p < .0001) in homes becoming smoke-free with increasing intensity of the intervention (control < Arm A < Arm B), and a decreasing trend (Z = -5.13; p < .0001) in social visibility at homes.
SFI has the potential to encourage children to negotiate a smoke-free environment in their homes.
接触二手烟对儿童健康构成威胁。我们开展了一项以学校为基础的无烟干预措施（SFI），以支持孟加拉国家庭实现无烟家庭，并收集了其有效性的初步证据。
在达卡市区米尔布尔的24所学校进行了一项SFI的可行性整群随机对照试验。采用简单分层随机化方法，将学校分为：A组（仅SFI）、B组（SFI加提醒）和C组（对照组）。共有781名来自同意参与研究的学校的五年级儿童（10 - 12岁）参与了该研究。通过研究人员在基线以及所有组别的第1、12、27和52周进行的基于问卷的儿童调查，评估了包括“无烟家庭”和“社会可见性”（即在孩子面前不在家中吸烟）等结果。
在第1年，当控制基线水平时，A组（优势比[OR]=4.8；95%置信区间[CI]=2.6 - 9.0）和B组（OR = 3.9；95% CI = 2.0 - 7.5）的“无烟家庭”比例显著高于C组。同样，在第1年，当控制基线水平时，A组（OR = 5.8；95% CI = 2.8 - 11.7）和B组（OR = 7.2；95% CI = 3.3 - 15.9）的“社会可见性”比C组显著降低。我们观察到随着干预强度增加（对照组 < A组 < B组），无烟家庭呈上升趋势（Cochrane Armitage检验统计量[Z]=3.8；p <.0001），家庭中的社会可见性呈下降趋势（Z = -5.13；p <.0001）。
SFI有潜力鼓励儿童在家中争取无烟环境。
