父母戒烟：对于家庭儿童烟草暴露的影响
2018/01/15
摘要
目的：对于吸烟或烟草暴露并没有安全或无风险分级。在此项随机对照研究中，在家庭中进行控烟干预，并针对吸烟的家长和/或看护人员（Ps/Cs）进行特定的戒烟干预，相应家中的儿童同步纳入烟草预防计划。
方法：Ps/Cs和来自14所城市和郊区小学的儿童纳入筛选。约1/4（24.3%，n=110）的Ps/Cs纳入随机对照研究（n=453）的受试者为吸烟者，其中主要为女性（80.9%）,平均年龄为37.7岁(SD 12.2）。62.7%为非洲裔美国人，44%低于高中教育程度，58%年收入低于20000美元。在第1年和第2年P/C吸烟者给予个体化戒烟策略。自我报道吸烟状态和唾液可体宁含量在基线，治疗结束和/或第2年和第4年随访期进行测定。
结果：随着时间推移，干预组Ps/Cs自我报道戒断率显著增加（EOT:6.5%[SE=5.7%]; 第4年：40.6%[SE=5.7%]）,优于对照组（EOT:0.0%[SE=6.5%]; 第4年：13.2%[SE=6.4%]）；F=4.82; P=0.0306; 对于可替宁浓度，干预组自基线开始逐步下降,基线239.9[SE=1.3]，EOT 221.1[SE=1.4]，维持至4年随访结束109.6[SE=1.4]，而对照组则较基线增加，基线221.1[SE=1.4]，EOT239.0[SE=1.4]，4年随访结束325.8[SE=1.4]；F=5.72; P0.0039。
结论：本研究证实在儿童学校中在儿童入组的控烟预防中给予Ps/Cs提供个体化戒烟策略可以帮助取得巨大成功并有效降低儿童烟草暴露。
Parental Smoking Cessation: Impacting Children's Tobacco Smoke Exposure in the Home.
Pediatrics. 2018 Jan;141(Suppl 1): S96-S106. doi: 10.1542/peds.2017-1026M.
Caldwell AL, Tingen MS, Nguyen JT, Andrews JO, Heath J, Waller JL, Treiber FA.
Abstract
OBJECTIVES:There is no safe or risk-free level of tobacco use or tobacco smoke exposure. In this randomized controlled trial, we tested a tobacco control intervention in families and specifically evaluated a tailored cessation intervention for the parents and/or caregivers (Ps/Cs) who were smokers while their children were simultaneously enrolled in tobacco prevention.
METHODS:Ps/Cs and children were recruited from 14 elementary schools across rural and urban settings. Approximately one-fourth (24.3%; n = 110) of the total Ps/Cs enrolled in the randomized controlled trial (n = 453) were smokers, predominantly women (80.9%), with a mean age of 37.7 years. (SD 12.2); 62.7% were African American, 44% had less than a high school education, and 58% earned <$20 000 annually. P/C smokers were offered a tailored cessation intervention in years 1 and 2. Self-report smoking status and saliva cotinine were obtained at baseline, the end of treatment (EOT) and/or year 2, and in the year 4 follow-up.
RESULTS:Ps/Cs in the intervention group showed a larger increase in self-reported smoking abstinence over time (EOT: 6.5% [SE = 5.7%]; year 4: 40.6% [SE = 5.7%]) than the control group (EOT: 0.0% [SE = 6.5%]; year 4: 13.2% [SE = 6.4%]; F = 4.82; P = .0306). For cotinine, the intervention group showed a decrease from baseline (239.9 [SE = 1.3]) to EOT 99.3 [SE = 1.4]) and then maintenance through year 4 (109.6 [SE = 1.4]), whereas the control group showed increases from baseline (221.1 [SE = 1.4]) to EOT (239.0 [SE = 1.4]) to year 4 (325.8 [SE = 14]; F = 5.72; P = .0039).
CONCLUSIONS:This study provides evidence that tailored cessation offered to Ps/Cs in their children's schools during their children's enrollment in tobacco prevention may contribute to more robust success in P/C cessation and a reduction of tobacco smoke exposure in children.
目的：对于吸烟或烟草暴露并没有安全或无风险分级。在此项随机对照研究中，在家庭中进行控烟干预，并针对吸烟的家长和/或看护人员（Ps/Cs）进行特定的戒烟干预，相应家中的儿童同步纳入烟草预防计划。
方法：Ps/Cs和来自14所城市和郊区小学的儿童纳入筛选。约1/4（24.3%，n=110）的Ps/Cs纳入随机对照研究（n=453）的受试者为吸烟者，其中主要为女性（80.9%）,平均年龄为37.7岁(SD 12.2）。62.7%为非洲裔美国人，44%低于高中教育程度，58%年收入低于20000美元。在第1年和第2年P/C吸烟者给予个体化戒烟策略。自我报道吸烟状态和唾液可体宁含量在基线，治疗结束和/或第2年和第4年随访期进行测定。
结果：随着时间推移，干预组Ps/Cs自我报道戒断率显著增加（EOT:6.5%[SE=5.7%]; 第4年：40.6%[SE=5.7%]）,优于对照组（EOT:0.0%[SE=6.5%]; 第4年：13.2%[SE=6.4%]）；F=4.82; P=0.0306; 对于可替宁浓度，干预组自基线开始逐步下降,基线239.9[SE=1.3]，EOT 221.1[SE=1.4]，维持至4年随访结束109.6[SE=1.4]，而对照组则较基线增加，基线221.1[SE=1.4]，EOT239.0[SE=1.4]，4年随访结束325.8[SE=1.4]；F=5.72; P0.0039。
结论：本研究证实在儿童学校中在儿童入组的控烟预防中给予Ps/Cs提供个体化戒烟策略可以帮助取得巨大成功并有效降低儿童烟草暴露。
（上海交通大学医学院附属瑞金医院呼吸与危重症医学科 周剑平 万欢英 摘译）
（Pediatrics. 2018 Jan;141(Suppl 1): S96-S106. doi: 10.1542/peds.2017-1026M.）
（Pediatrics. 2018 Jan;141(Suppl 1): S96-S106. doi: 10.1542/peds.2017-1026M.）
Parental Smoking Cessation: Impacting Children's Tobacco Smoke Exposure in the Home.
Pediatrics. 2018 Jan;141(Suppl 1): S96-S106. doi: 10.1542/peds.2017-1026M.
Caldwell AL, Tingen MS, Nguyen JT, Andrews JO, Heath J, Waller JL, Treiber FA.
Abstract
OBJECTIVES:There is no safe or risk-free level of tobacco use or tobacco smoke exposure. In this randomized controlled trial, we tested a tobacco control intervention in families and specifically evaluated a tailored cessation intervention for the parents and/or caregivers (Ps/Cs) who were smokers while their children were simultaneously enrolled in tobacco prevention.
METHODS:Ps/Cs and children were recruited from 14 elementary schools across rural and urban settings. Approximately one-fourth (24.3%; n = 110) of the total Ps/Cs enrolled in the randomized controlled trial (n = 453) were smokers, predominantly women (80.9%), with a mean age of 37.7 years. (SD 12.2); 62.7% were African American, 44% had less than a high school education, and 58% earned <$20 000 annually. P/C smokers were offered a tailored cessation intervention in years 1 and 2. Self-report smoking status and saliva cotinine were obtained at baseline, the end of treatment (EOT) and/or year 2, and in the year 4 follow-up.
RESULTS:Ps/Cs in the intervention group showed a larger increase in self-reported smoking abstinence over time (EOT: 6.5% [SE = 5.7%]; year 4: 40.6% [SE = 5.7%]) than the control group (EOT: 0.0% [SE = 6.5%]; year 4: 13.2% [SE = 6.4%]; F = 4.82; P = .0306). For cotinine, the intervention group showed a decrease from baseline (239.9 [SE = 1.3]) to EOT 99.3 [SE = 1.4]) and then maintenance through year 4 (109.6 [SE = 1.4]), whereas the control group showed increases from baseline (221.1 [SE = 1.4]) to EOT (239.0 [SE = 1.4]) to year 4 (325.8 [SE = 14]; F = 5.72; P = .0039).
CONCLUSIONS:This study provides evidence that tailored cessation offered to Ps/Cs in their children's schools during their children's enrollment in tobacco prevention may contribute to more robust success in P/C cessation and a reduction of tobacco smoke exposure in children.
上一篇：
保护儿童免受烟草暴露危害：零暴露计划探索性研究
下一篇：
办公室启动多层次控烟干预：一项随机研究
