From the Department of Paediatrics and Allergy, N. Copernicus Memorial Hospital, Medical University of Lodz, Lodz, Poland, and.
Social Medicine Institute, Department of Social and Preventive Medicine, Medical University of Lodz, Lodz, Poland.
Allergy Asthma Proc. 2020 May 1;41(3):198-203. doi: 10.2500/aap.2020.41.200010.
Interventions to help parents quit smoking may yield important benefits for children with asthma. Children's exposure to environmental tobacco smoke can be measured by reporting of an adult in the household and testing the child's biomarker, e.g., cotinine. The aim of the study was to assess the effectiveness of "face-to-face" intervention carried out since 2016 in families with children diagnosed with asthma 3 years after beginning the anti-tobacco intervention. This study was a follow-up to an interventional study that assessed the effectiveness of direct patient education versus educational leaflets alone about parental tobacco smoking. The patients with asthma (ages 4-17 years) enrolled in our original intervention study conducted in 2016 were under the care of the allergy outpatient clinic. The active group was individually educated about the harmful effects of environmental tobacco smoke on their children. The control group included patients and parents, among whom only leaflets were distributed. After 3 years of ongoing intervention, in patients from both groups, exposure to tobacco smoking was evaluated with a questionnaire addressed to parents and/or caregivers and measurement of cotinine in children's urine. The forced expiratory volume in the first second of expiration and fractional exhaled nitric oxide levels were measured. Seventy participants completed the study: 37 in the active group and 33 in the control group. In the active group, 27% of the parents quit smoking entirely compared with 9.4% of parents in the control group. In the group of active intervention, a significant decrease in the cotinine level (p < 0 .001) and the number of cigarettes smoked daily were observed (p < 0.001) 3 years after the active intervention compared with values right after the intervention. In the control group, there were no significant changes in the above-mentioned parameters. "Face-to-face" intervention among families with smokers were effective and lowered cotinine levels in children with asthma and the number of cigarettes smoked assessed 3 years after the intervention.
帮助父母戒烟的干预措施可能会给患有哮喘的儿童带来重要的益处。儿童接触环境烟草烟雾可以通过报告家庭中的成年人并测试儿童的生物标志物（例如可替宁）来测量。本研究的目的是评估自 2016 年以来对被诊断患有哮喘的儿童家庭进行的“面对面”干预的有效性，该干预在开始反烟草干预 3 年后进行评估。这项研究是一项干预研究的后续研究，该研究评估了直接对患者进行教育与单独发放有关父母吸烟的教育传单相比的有效性。2016 年进行的原始干预研究中招募的哮喘患者（年龄在 4-17 岁之间）在过敏门诊接受治疗。实验组接受了关于环境烟草烟雾对子女有害影响的个别教育。对照组包括患者及其父母，其中仅发放了传单。在持续干预 3 年后，在两组患者中，通过向父母和/或照顾者发放问卷以及测量儿童尿液中的可替宁来评估吸烟暴露情况。还测量了呼气第一秒用力呼气量和呼出的一氧化氮分数。70 名参与者完成了研究：实验组 37 名，对照组 33 名。在实验组中，27%的父母完全戒烟，而对照组中只有 9.4%的父母戒烟。在积极干预组中，与干预后立即相比，可替宁水平（p < 0.001）和每日吸烟量（p < 0.001）在积极干预 3 年后显著下降。在对照组中，上述参数没有显著变化。针对吸烟者家庭的“面对面”干预措施是有效的，可以降低哮喘儿童的可替宁水平和干预 3 年后评估的吸烟量。
