Abstract
BackgroundDespite the low prevalence of daily smokers in Sweden, children are still being exposed to environmental tobacco smoke (ETS), primarily by their smoking parents. A prospective intervention study using methods from Quality Improvement was performed in Child Health Care (CHC). The aim was to provide nurses with new methods for motivating and supporting parents in their efforts to protect children from ETS exposure.MethodCollaborative learning was used to implement and test an intervention bundle. Twenty-two CHC nurses recruited 86 families with small children which had at least one smoking parent. Using a bundle of interventions, nurses met and had dialogues with the parents over a one-year period. A detailed questionnaire on cigarette consumption and smoking policies in the home was answered by the parents at the beginning and at the end of the intervention, when children also took urine tests to determine cotinine levels.ResultsSeventy-two families completed the study. Ten parents (11%) quit smoking. Thirty-two families (44%) decreased their cigarette consumption. Forty-five families (63%) were outdoor smokers at follow up. The proportion of children with urinary cotinine values of >6 ng/ml had decreased.ConclusionThe intensified tobacco prevention in CHC improved smoking parents’ ability to protect their children from ETS exposure.
Highlights
Despite the low prevalence of daily smokers in Sweden, children are still being exposed to environmental tobacco smoke (ETS), primarily by their smoking parents
Sixteen per cent (n = 14) of the families who answered the Smoking in Children’s Environment Test (SiCET) at base-line left the study during the intervention (Figure 2)
The combined results from these groups showed a decrease of smokers in families when the child was 8 months of age, from 20% in 2009 to 12% in 2011 as shown in Table 5 together with the national and regional data for comparison
Summary
Despite the low prevalence of daily smokers in Sweden, children are still being exposed to environmental tobacco smoke (ETS), primarily by their smoking parents. The aim was to provide nurses with new methods for motivating and supporting parents in their efforts to protect children from ETS exposure. Children’s exposure to tobacco smoke is primarily attributable to their smoking parents. Smoking parents often use different strategies to minimize children’s exposure to environmental tobacco smoke (ETS) [1,2,3]. Several dimensions of socioeconomic positions have to be considered in explanations of social inequalities in families’ home smoking practices and children’s ETS exposure [12,13]. Swedish studies have shown that selective actions to reach these families are not carried out by CHC nurses [14], they experience difficulties in contact with foreign born parents and they miss support in their mission [15]
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