保护儿童免受烟草暴露危害：零暴露计划探索性研究
2018/01/15
摘要
背景：烟草暴露（TSE）对于儿童健康有害，即家庭中的被动吸烟者。零暴露计划是一项有家长为导向，以理论为基础的干预措施旨在降低儿童TSE。本文将一项以色列2013~2104年进行的探索性研究的结果进行报道。
方法：干预措施包括激励性谈话，儿童生物标志物和家庭空气治疗反馈，网站、视频和自我帮助等材料。首要研究终点为儿童头发尼古丁含量。次要终点包括空气中尼古丁和颗粒物质含量，家长吸烟行为，和TSE儿童保护。单一组别测试前后数据进行比较。
结果：纳入29个家庭中，26个家庭完成研究。干预措施对于所有受试者而言均可行且容易接受。17位儿童基线期取得可靠头发样本，在随访中头发尼古丁对数在干预后呈显著下降（p=0.04），头发尼古丁含量在64.7%儿童中出现下降，且下降至无烟草暴露儿童水平比例达到35.3%。家长吸烟数量（p=0.001）和家长报道的儿童TSE均显著下降（p=0.01）。回归分析纳入有所客观指标，包括空气中尼古丁并未下降；家庭空气颗粒和头发尼古丁含量。
结论：激励性谈话和提示TSE危害对于吸烟家长而言是一个简便且行之有效的方法，进而保护儿童免受TSE危害。需要进一步研究增强测定手段和评估干预措施。
Protecting Young Children From Tobacco Smoke Exposure: A Pilot Study of Project Zero Exposure.
Pediatrics. 2018 Jan;141(Suppl 1):S107-S117. doi: 10.1542/peds.2017-1026N.
Rosen L, Guttman N, Myers V, Brown N, Ram A, Hovell M, Breysse P, Rule A, Berkovitch M, Zucker D.
Abstract
BACKGROUND:Tobacco smoke exposure (TSE) harms children, who are often "captive smokers" in their own homes. Project Zero Exposure is a parent-oriented, theory-based intervention designed to reduce child TSE. This paper reports on findings from the pilot study, which was conducted in Israel from 2013 to 2014.
METHODS:The intervention consisted of motivational interviews, child biomarker and home air quality feedback, a Web site, a video, and self-help materials. The primary outcome was child TSE as measured by hair nicotine. Secondary outcome measures were air nicotine and particulate matter, parental reports of TSE, parental smoking behavior, and TSE child protection. A single-group pre- and posttest design was used.
RESULTS:Twenty-six of the 29 recruited families completed the study. The intervention was feasible to implement and acceptable to participants. Among the 17 children with reliable hair samples at baseline and follow-up, log hair nicotine dropped significantly after the intervention (P = .04), hair nicotine levels decreased in 64.7% of children, and reductions to levels of nonexposed children were observed in 35.3% of children. The number of cigarettes smoked by parents (P = .001) and parent-reported child TSE declined (P = .01). Logistical issues arose with measurement of all objective measures, including air nicotine, which did not decline; home air particulate matter; and hair nicotine.
CONCLUSIONS:A program based on motivational interviewing and demonstrating TSE and contamination to parents in a concrete and easily understandable way is a promising approach to protect children from TSE. Further research is needed to enhance current methods of measurement and assess promising interventions.
背景：烟草暴露（TSE）对于儿童健康有害，即家庭中的被动吸烟者。零暴露计划是一项有家长为导向，以理论为基础的干预措施旨在降低儿童TSE。本文将一项以色列2013~2104年进行的探索性研究的结果进行报道。
方法：干预措施包括激励性谈话，儿童生物标志物和家庭空气治疗反馈，网站、视频和自我帮助等材料。首要研究终点为儿童头发尼古丁含量。次要终点包括空气中尼古丁和颗粒物质含量，家长吸烟行为，和TSE儿童保护。单一组别测试前后数据进行比较。
结果：纳入29个家庭中，26个家庭完成研究。干预措施对于所有受试者而言均可行且容易接受。17位儿童基线期取得可靠头发样本，在随访中头发尼古丁对数在干预后呈显著下降（p=0.04），头发尼古丁含量在64.7%儿童中出现下降，且下降至无烟草暴露儿童水平比例达到35.3%。家长吸烟数量（p=0.001）和家长报道的儿童TSE均显著下降（p=0.01）。回归分析纳入有所客观指标，包括空气中尼古丁并未下降；家庭空气颗粒和头发尼古丁含量。
结论：激励性谈话和提示TSE危害对于吸烟家长而言是一个简便且行之有效的方法，进而保护儿童免受TSE危害。需要进一步研究增强测定手段和评估干预措施。
（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):S107-S117. doi: 10.1542/peds.2017-1026N.）
（Pediatrics. 2018 Jan;141(Suppl 1):S107-S117. doi: 10.1542/peds.2017-1026N.）
Protecting Young Children From Tobacco Smoke Exposure: A Pilot Study of Project Zero Exposure.
Pediatrics. 2018 Jan;141(Suppl 1):S107-S117. doi: 10.1542/peds.2017-1026N.
Rosen L, Guttman N, Myers V, Brown N, Ram A, Hovell M, Breysse P, Rule A, Berkovitch M, Zucker D.
Abstract
BACKGROUND:Tobacco smoke exposure (TSE) harms children, who are often "captive smokers" in their own homes. Project Zero Exposure is a parent-oriented, theory-based intervention designed to reduce child TSE. This paper reports on findings from the pilot study, which was conducted in Israel from 2013 to 2014.
METHODS:The intervention consisted of motivational interviews, child biomarker and home air quality feedback, a Web site, a video, and self-help materials. The primary outcome was child TSE as measured by hair nicotine. Secondary outcome measures were air nicotine and particulate matter, parental reports of TSE, parental smoking behavior, and TSE child protection. A single-group pre- and posttest design was used.
RESULTS:Twenty-six of the 29 recruited families completed the study. The intervention was feasible to implement and acceptable to participants. Among the 17 children with reliable hair samples at baseline and follow-up, log hair nicotine dropped significantly after the intervention (P = .04), hair nicotine levels decreased in 64.7% of children, and reductions to levels of nonexposed children were observed in 35.3% of children. The number of cigarettes smoked by parents (P = .001) and parent-reported child TSE declined (P = .01). Logistical issues arose with measurement of all objective measures, including air nicotine, which did not decline; home air particulate matter; and hair nicotine.
CONCLUSIONS:A program based on motivational interviewing and demonstrating TSE and contamination to parents in a concrete and easily understandable way is a promising approach to protect children from TSE. Further research is needed to enhance current methods of measurement and assess promising interventions.
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主动戒烟者情感失调和吸烟行为
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父母戒烟：对于家庭儿童烟草暴露的影响
