Learning Objectives: Describe the effect of measurement on children's reported exposure to environmental tobacco smoke, including predictors of change over time.
Abstract: Mothers who exposed their young children to at least three cigarettes per day in the home were recruited to a randomized controlled trial. Bogus environmental nicotine dosimeters were placed in homes and three baseline interviews concerning health behaviors -- including smoking and children’s exposure to environmental tobacco smoke (ETS), and children’s urine collections for cotinine analysis were conducted prior to randomization. After the third baseline, 40.4% of 90 mothers reported fewer than three cigarettes per day exposure. Repeated measures ANOVA showed a statistically significant time effect (p=.001), with geometric means for ETS exposure from mothers in the home decreasing from 3.81 to 3.07 cigarettes per day. Significant covariates were home smoking policy, mothers’ heaviness of smoking index (HSI), number of smokers in the home (negative), the degree to which other adults in the home made it difficult to protect the child from ETS, and mothers’ self efficacy for protecting the child from ETS (negative). Mothers who reported at least 10 cigarettes per week exposure at their third baseline were randomized. One-way ANOVA showed that randomized mothers (n=76) scored higher on HSI, lower on self efficacy, and reported higher exposure levels at their first baseline (4.30 vs.1.83 cigarettes per day). Results indicate that measurement alone may cause ETS exposure to decrease among some families, and suggest that encouraging families to adopt more stringent home smoking policies and assisting mothers with coping with other smokers in the home who impede tobacco control are important targets for preventive interventions.
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