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Nicotine Tob Res. 2015 Dec;17(12):1465-72. doi: 10.1093/ntr/ntv015. Epub 2015 Jan 29.

Children Learning About Second-Hand Smoking: A Feasibility Cluster Randomized Controlled Trial.

Author information

Department of Economics, University of Dhaka, Dhaka, Bangladesh;
Department of Health Sciences, University of York, York, UK;
Leeds City Council, Leeds, UK;
Office of the Director of Public Health, Leeds City Council, Leeds, UK;
Centre for Population Health Sciences Medical School, University of Edinburgh, Edinburgh, UK;
Department of Health Sciences/Hull York Medical School, University of York, York, UK.



Exposure to second-hand smoke is a threat to children's health. We developed a school-based smoke-free intervention (SFI) to support families in implementing smoke-free homes in Bangladesh, and gathered preliminary evidence of its effectiveness.


A feasibility cluster randomized controlled trial of SFI was conducted in 24 schools in Mirpur, an urban area within Dhaka. Using simple stratified randomization, schools were allocated to: Arm A (SFI only), Arm B (SFI plus reminders), and Arm C (the control group). A total of 781 year-5 children (10-12 years old) in the consenting schools, participated in the study. Outcomes including "smoke-free homes" and "social visibility" that is, not smoking in front of children at home were assessed through questionnaire-based children's surveys, administered by researchers, at baseline and at weeks 1, 12, 27, and 52 in all arms.


"Smoke-free homes" were significantly higher in Arm A (odds ratio [OR] = 4.8; 95% CI = 2.6-9.0) and in Arm B (OR = 3.9; 95% CI = 2.0-7.5) than in Arm C, when controlled for the baseline levels, at year 1. Similarly, "social visibility" was significantly reduced in Arm A (OR = 5.8; 95% CI = 2.8-11.7) and in Arm B (OR = 7.2; 95% CI = 3.3-15.9) than Arm C, when controlled for the baseline levels, at year 1. We observed an increasing trend (Cochrane Armitage test statistic [Z] = 3.8; p < .0001) in homes becoming smoke-free with increasing intensity of the intervention (control < Arm A < Arm B), and a decreasing trend (Z = -5.13; p < .0001) in social visibility at homes.


SFI has the potential to encourage children to negotiate a smoke-free environment in their homes.

[Indexed for MEDLINE]

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