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    Moms Get Help Reducing Tobacco Smoke in Home

    Researchers recently developed a way to help parents reduce their child's exposure to tobacco smoke in the home. S.R. Wilson from the Palo Alto Medical Foundation Research Institute in Palo Alto, California, presented the results of a study on this new approach at the 96th International Conference of the American Thoracic Society in Toronto.

    Scientists know that exposure to tobacco smoke makes kids' asthma worse, and recent research suggests that their symptoms improve when their exposure is reduced or eliminated. But getting families to stop smoking in the home is easier said than done, and many kids continue to be exposed to tobacco smoke in the home.

    Wilson and her colleagues created a program that helps parents develop the skills they need to maintain a smoke-free home while providing them with a way to measure their success. The study consisted of 87 children from age three to 12, who were exposed to tobacco smoke in the home and who had been seen either in an emergency department or a medical clinic for their asthma.

    Finding people willing to participate in the program was a challenge: out of 274 children who were eligible for the study only 172 agreed to be part of the study, and of those, 85 failed to show up for their appointments.

    Mothers were divided into two groups, and they were all seen by a nurse for three visits. One group received minimal education during their visits; the other mothers were given education and practical help in dealing with difficulties they encountered trying to eliminate tobacco smoke in the home. These mothers also were given results of a test that measured cotinine (a by-product of tobacco metabolism that indicates exposure to tobacco smoke) in their child's urine as a way to measure their progress.

    In addition to basic asthma education, the second group of mothers spent time with the nurse looking at specific things that made it difficult for them to eliminate smoke from their home. Interestingly, 40 percent of the mothers in the study did not smoke themselves. Rather, a family member living in the home was the one smoking (many of these were low-income women who lived with their own parents).

    The nurse helped the women develop ways to deal with others who smoked in the home -- for example, role-playing and helping them to stand up to others. In addition, mothers were given written instructions to eliminate smoke from the home, which they could give to family members who smoked. The mothers had the option of bringing the smoker(s) in for the third session as well.

    During the 12 months after the program, the children whose mothers had received the additional support were less likely to be seen more than once for their asthma, and less likely to be hospitalized more than once.

    The study also showed that giving mothers results of urine cotinine tests at each visit (so they could compare results to specific things they were doing in the home) was more effective than simply measuring the child's cotinine level one time, which was found to be ineffective.

    Wilson explained that there might be better ways of measuring exposure to tobacco smoke. But to date, "It's the best marker we have, and it's far from perfect".



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