家庭和职业控制计划减少儿童环境性吸烟的暴露
2009/07/30
目的：测定介入因素减少儿童环境性吸烟的暴露的有效性。
方法：我们研究吸烟成瘾的这项实验的实验是2007年10月。
选择标准：介入实验用了对照试验，如果参与者来自于同一个家庭，则进行随机分配的原则。
受试者有：患者和其家庭成员、儿童、工人和教师。儿童包括婴儿和幼儿（年龄为0～12岁）。
方法：我们研究吸烟成瘾的这项实验的实验是2007年10月。
选择标准：介入实验用了对照试验，如果参与者来自于同一个家庭，则进行随机分配的原则。
受试者有：患者和其家庭成员、儿童、工人和教师。儿童包括婴儿和幼儿（年龄为0～12岁）。
所有减少儿童吸烟暴露的因素：阻止吸烟、戒烟、程序控制都包含在内。这些包含了吸烟自由的政策、法规、健康教育和社会行为治疗。
数据分析：两名研究者对研究结果进行分析。
结果：内科医师陈述时已经证明简短的咨询是有效的，这个不能被推知作为亲代的父母是儿童暴露的健康环境。但是在这篇文章里，对父母更加有效地健康咨询报到是有限的。在有呼吸疾病和没有呼吸疾病的儿童方面没有明显的不同，健康儿童和分娩期儿童都应减少环境性吸烟的暴露。
（孙力超编译 刘国梁审校）
Cochrane Database Syst Rev. 2008 Oct 8;(4):CD001746
Family and carer smoking control programmes for reducing children’s exposure to environmental tobacco smoke.
Priest N, Roseby R, Waters E, Polnay A, Campbell R, Spencer N, Webster P, Ferguson-Thorne G.
Cochrane Database Syst Rev. 2008 Oct 8;(4):CD001746.
McCaughey Centre, Melbourne School of Population Health, University of Melbourne, 5/207 Bouverie St, Parkville, VIC, Australia, 3052. npriest@unimelb.edu.au
BACKGROUND: Children’s exposure to other people’s cigarette smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children’s exposure to ETS. Preventing exposure to cigarette smoke in infancy and childhood has significant potential to improve children’s health worldwide.
OBJECTIVES: To determine the effectiveness of interventions aiming to reduce exposure of children to ETS.
SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group trials register and conducted additional searches of two health and education databases not included in this specialised register. Date of the most recent search: October 2007.
SELECTION CRITERIA: Interventions tested using controlled trials with or without random allocation were included in this review if the interventions addressed participants (parents and other family members, child care workers and teachers) involved with the care and education of infants and young children (aged 0-12 years). All mechanisms for reduction of children’s environmental tobacco smoke exposure, and smoking prevention, cessation, and control programmes were included. These include smoke-free policies and legislation, health promotion, social-behavioural therapies, technology, education and clinical interventions.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed studies and extracted data. Due to heterogeneity of methodologies and outcomes, no summary measures were possible and results were synthesised using narrative summaries.
MAIN RESULTS: Thirty-six studies met the inclusion criteria. Four interventions were targeted at populations or community settings, 16 studies were conducted in the ’well child’ healthcare setting and 13 in the ’ill child’ healthcare setting. Two further studies conducted in paediatric clinics do not make clear whether the visits are to well or ill children, and another includes both well and ill child visits. Nineteen of these studies are from North America and 12 in other high income countries. Five studies are from low- or middle-income countries. In 17 of the 36 studies there was reduction of ETS exposure for children in both intervention and comparison groups. In only 11 of the 36 studies was there a statistically significant intervention effect. Four of these successful studies employed intensive counselling interventions targeted to smoking parents. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness and other child illness settings as contexts for parental smoking cessation interventions. One successful intervention was in the school setting, targeting the ETS exposure of children from smoking fathers.
AUTHORS’ CONCLUSIONS: While brief counselling interventions have been identified as successful ifor adults when delivered by physicians, this cannot be extrapolated to adults as parents in child health settings. However, there is limited support for more intensive counselling interventions for parents in such contexts. There is no clear evidence of differences between the respiratory, non-respiratory ill child, well child and peripartum settings as contexts for reduction of children’s ETS exposure.
PMID: 18843622 [PubMed - indexed for MEDLINE]
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