Effectiveness of Non-Pharmacologic Strategies for Parental Smoking Cessation to Protect Children: A Meta-Analytic Review

Stefanie Nichole Tan, Jose H. Caduhada, Ma Teresa Tricia G. Bautista

Dec 2021 DOI 10.35460/2546-1621.2021-0014     Access   

Abstract

Aims: This meta-analysis aims to synthesize available evidence from published studies on the effectiveness of parental non-pharmacologic smoking cessation programs which aim to reduce children’s exposure to secondhand smoke.
 

Methodology: A database search using The Cochrane Library, PubMed®, Medline, Embase, and Google Scholar, was done by the investigators. This study included 20 randomized controlled trials published up to 2020. Pooled estimates of risk ratio (RR) for quit rates were computed using the random effects model.
 

Results: Overall, the quit rate among those who underwent parental smoking cessation was 13.4% while the quit rate for controls was 11.9%. The pooled RR demonstrated that the parental smoking cessation program was significantly associated with higher quit rates (RR = 1.22, 95%CI = 1.01 to 1.46, p-value = 0.04). The studies demonstrated moderate heterogeneity only (I2 = 54%). Among studies published prior to year 2000, no significant difference was observed between parental smoking cessation program and control (RR = 1.02, 95% CI = 0.62 to 1.70, p-value = 0.93). On the other hand, the pooled RR demonstrated that among studies published after 2020, parental smoking cessation program was significantly associated with higher quit rates (RR = 1.27, 95%CI = 1.03 to 1.56, p-value <0.0001). Among studies with self-help interventions, parental smoking cessation program has no additional benefit on quit rates (RR = 1.20, 95%CI = 0.94 to 1.58, p-value = 0.14). Among studies with biofeedback intervention also, no significant difference was observed (RR = 1.27, 95% CI = 0.86 to 1.89, p-value = 0.23).
 

Conclusions: This meta-analysis demonstrated sufficient evidence that non-pharmacologic interventions for parental smoking cessation are effective.

 

Key words: smoking cessation, second-hand smoke, family interventions, non-pharmacologic, meta-analysis

 

  1. World Health Organization. 2020. Available from: https://www.who.int/news/item/08-12-2020-who-launches-year-long-campaign-to-help-100-million-people-quit-tobacco
  2. Centers for Disease Control and Prevention. 2020. Available from: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm#:~:text=Cigarette%20smoking%20is%20responsible%20for,or%201%2C300%20deaths%20every%20day.&text=On%20average%2C%20smokers%20die%2010%20years%20earlier%20than%20nonsmokers.
  3. Legg T. 2017. Available from: https://www.healthline.com/health/copd/smoking-relapse#:~:text=The%20most%20common%20causes%20of,you%20decide%20to%20quit%20smoking.
  4. World Health Organization. WHO Report on the Global Tobacco Epidemic, 2019. Geneva: World Health Organization, 2019 [cited 2021 Jan 26].
  5. Brewer NT, Chapman GB, Gibbons FX, Gerrard M, McCaul KD, Weinstein ND. Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol. 2007;26(2):136–45.
  6. Hubbard G, Gorely T, Ozakinci G, Polson R, Forbat L. A systematic review and narrative summary of family-based smoking cessation interventions to help adults quit smoking. BMC Family Practice. 2016;17(1):1–20.
  7. Priest N, Roseby R, Waters E, Polnay A, Campbell R, Spencer N, et al. Family and carer smoking control programmes for reducing children’s exposure to environmental tobacco smoke. Cochrane Database Syst Rev [Internet]. 2008;(4):CD001746. Available from: http://dx.doi.org/10.1002/14651858.CD001746.pub2
  8. Rosen LJ, Noach MB, Winickoff JP, Hovell MF. Parental smoking cessation to protect young children: a systematic review and meta-analysis. Pediatrics. 2012;129(1):141–52. doi:10.1542/peds.2010-3209
  9. Caldwell AL, Tingen MS, Nguyen JT, Andrews JO, Heath J, Waller JL, et al. Parental smoking cessation: Impacting children’s tobacco smoke exposure in the home. Pediatrics. 2018;141(Supplement 1):S96–106.
  10. Bricker J, Leroux BG, Peterson AV, Kealey KA, Sarason IG, Andersen MR, et al. Nine-year prospective relationship between parental smoking cessation and children's daily smoking. Addiction. 2003;98(5):585–93.
  11. Chassin L, Presson C, Rose J, Sherman SJ, Prost J. Parental smoking cessation and adolescent smoking. Journal of Pediatric Psychology. 2002;27(6):485–96.
  12. Schuck K, Bricker JB, Otten R, Kleinjan M, Brandon TH, Engels RC. Effectiveness of proactive quitline counselling for smoking parents recruited through primary schools: results of a randomized controlled trial. Addiction. 2014;109(5):830–41.
  13. Abdullah AS, Hua F, Khan H, Xia X, Bing Q, Tarang K, et al. Secondhand smoke exposure reduction intervention in Chinese households of young children: a randomized controlled trial. Academic Pediatrics. 2015;15(6):588–98.
  14. Abdullah ASM, Mak YW, Loke AY, Lam TH. Smoking cessation intervention in parents of young children: a randomised controlled trial. Addiction. 2005;100(11):1731–40.
  15. Borrelli B, McQuaid EL, Tooley EM, Busch AM, Hammond SK, Becker B, et al. Motivating parents of kids with asthma to quit smoking: the effect of the teachable moment and increasing intervention intensity using a longitudinal randomized trial design. Addiction. 2016;111(9):1646–55.
  16. Chan SSC, Lam TH, Salili F, Leung GM, Wong DCN, Botelho RJ, et al. A randomized controlled trial of an individualized motivational intervention on smoking cessation for parents of sick children: a pilot study. Appl Nurs Res [Internet]. 2005;18(3):178–81. Available from: http://dx.doi.org/10.1016/j.apnr.2005.01.002
  17. Chan SSC, Cheung YTD, Fong DYT, Emmons K, Leung AYM, Leung DYP, et al. Family-based smoking cessation intervention for smoking fathers and nonsmoking mothers with a child: a randomized controlled trial [published correction appears in J Pediatr. 2017 Jun;185:255]. J Pediatr. 2017;182:260–266.e4. doi:10.1016/j.jpeds.2016.11.021
  18. Curry SJ, Ludman EJ, Graham E, Stout J, Grothaus L, Lozano P. Pediatric-based smoking cessation intervention for low-income women: a randomized trial. Arch Pediatr Adolesc Med. 2003;157(3):295–302.
  19. Eriksen W, Sørum K, Bruusgaard D. Effects of information on smoking behaviour in families with preschool children. Acta Paediatr [Internet]. 1996;85(2):209–12. Available from: http://dx.doi.org/10.1111/j.1651-2227.1996.tb13994.x
  20. Greenberg RA, Strecher VJ, Bauman KE, Boat BW, Fowler MG, Keyes LL, et al. Evaluation of a home‐based intervention program to reduce infant passive smoking and lower respiratory illness. Journal of Behavioral Medicine. 1994;17(3):273–90.
  21. Hovell MF, Meltzer SB, Wahlgren DR, Matt GE, Hofstetter CR, Jones JA, et al. Asthma management and environmental tobacco smoke exposure reduction in Latino children: a controlled trial. Pediatrics [Internet]. 2002;110(5):946–56. Available from: http://dx.doi.org/10.1542/peds.110.5.946
  22. Hughes DM, McLeod M, Garner B, Goldbloom RB. Controlled trial of a home and ambulatory program for asthmatic children. Pediatrics. 1991;87(1):54–61.
  23. Kallio K, Jokinen E, Hämäläinen M, Kaitosaari T, Volanen I, Viikari J, et al. Impact of repeated lifestyle counselling in an atherosclerosis prevention trial on parental smoking and children’s exposure to tobacco smoke. Acta Paediatr [Internet]. 2006;95(3):283–90. Available from: http://dx.doi.org/10.1080/08035250500375145
  24. Krieger JW, Takaro TK, Song L, Weaver M. The Seattle-King County Healthy Homes Project: a randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers. Am J Public Health [Internet]. 2005;95(4):652–9. Available from: http://dx.doi.org/10.2105/AJPH.2004.042994
  25. Severson HH, Andrews JA, Lichtenstein E, Wall M, Akers L. Reducing maternal smoking and relapse: long-term evaluation of a pediatric intervention. Prev Med. 1997;26 (1):120–30.
  26. Vineis P, Ronco G, Ciccone G, Vernero E, Troia B, D’Incalci T, et al. Prevention of exposure of young children to parental tobacco smoke: effectiveness of an educational program. Tumori [Internet]. 1993;79(3):183–6. Available from: http://dx.doi.org/10.1177/030089169307900304.
  27. Wahlgren DR, Hovell MF, Meltzer SB, Hofstetter CR, Zakarian JM. Reduction of environmental tobacco smoke exposure in asthmatic children. A 2-year follow-up. Chest [Internet]. 1997;111(1):81–8. Available from: http://dx.doi.org/10.1378/chest.111.1.81
  28. Wilson S, Farber H, Knowles S, Lavori P. A randomized trial of parental behavioral counseling and cotinine feedback for lowering environmental tobacco smoke exposure in children with asthma: results of the LET’S Manage Asthma trial. Chest. 2011;139(3):581–90.
  29. Woodward A, Owen N, Grgurinovich N, Griffith F, Linke H. Trial of an intervention to reduce passive smoking in infancy. Pediatric Pulmonology. 1987;3(3):173–8.
  30. Yilmaz G, Karacan C, Yöney A, Yilmaz T. Brief intervention on maternal smoking: a randomized controlled trial. Child Care Health Dev [Internet]. 2006;32(1):73–9. Available from: http://dx.doi.org/10.1111/j.1365-2214.2006.00570.x
  31. Zakarian JM, Hovell MF, Sandweiss RD, Hofstetter CR, Matt GE, Bernert JT, et al. Behavioral counseling for reducing children’s ETS exposure: implementation in community clinics. Nicotine Tob Res [Internet]. 2004;6(6):1061–74. Available from: http://dx.doi.org/10.1080/1462220412331324820

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