Effectiveness of Interventions to Reduce Exposure to Parental Secondhand Smoke at Home among Children in China: A Systematic Review.

Yan Hua Zhou,Yim Wah Mak,Grace W K Ho

doi:10.3390/ijerph16010107

Abstract

There are health consequences to exposure to secondhand smoke (SHS). About two-thirds of children in China live with at least one person, usually a parent, who smokes at home. However, none of the reviews of interventions for reducing SHS have targeted children in China. The purpose of this study was to review the effectiveness of interventions for reducing parental SHS exposure at home among children in China. We searched various electronic databases for English and Chinese publications appearing between 1997 and 2017. Thirteen relevant studies were identified. Common strategies used in intervention groups were non-pharmacological approaches such as counseling plus self-help materials, and attempting to persuade fathers to quit smoking. Family interactions and follow-up sessions providing counseling or using text messages could be helpful to successful quitting. Several encouraging results were observed, including lower cotinine levels in children (n = 2), reduced tobacco consumption (n = 5), and increased quit rates (n = 6) among parents. However, the positive effects were not sustained 3~6 months after the interventions. Self-reported quitting without bio-chemical validation was the most common outcome measure. A study design using biochemical validations, a longer follow-up period, and targeting all people living with children in the same household is recommended.

Highlights

Second-hand smoke (SHS), called passive smoke, or environmental tobacco smoke, is defined as “the combination of smoke emitted from the burning end of a cigarette or other tobacco products and smoke exhaled by the smoker” [1]
The keywords for our search included a combination of terms related to secondhand smoking exposure and terms related to Chinese children and their families
In China, it is good manners to share cigarettes with others, even strangers, and to give cigarettes as gifts [56]. These findings suggest that more research is needed to understand whether and how wider public health initiatives aimed at changing attitudes towards smoking, as well as the implementation of tobacco-control policies that discourage the giving of cigarettes as gifts, may help to sustain the effects of smoking cessation interventions in the long-run

Summary

Introduction

Second-hand smoke (SHS), called passive smoke, or environmental tobacco smoke, is defined as “the combination of smoke emitted from the burning end of a cigarette or other tobacco products and smoke exhaled by the smoker” [1]. A growing body of evidence suggests that exposure to SHS has negative consequences for both children and society. Children exposed to SHS are more likely to develop middle ear disease, respiratory symptoms, impaired lung function, lower respiratory illness, and sudden infant death syndrome [2]. A child’s exposure to SHS at home during the primary school years is a predictor of smoking initiation [3]. Exposure to SHS places a heavy economic burden on the healthcare system. SHS exposure-related health conditions contribute significantly to healthcare expenditures for children and adults. Medical and other indirect costs of SHS exposure among children living in public housing were estimated to be approximately $182 million in the US in 2011, while the corresponding figure for adult public housing residents was over $123 billion [4]

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