This article is more than 5 years old. Information may no longer be current.

Interventions prevent smoking relapse in postpartum women, fail to reduce smoke exposure in children

A recent meta-analysis showed that parent-targeted interventions did not reduce tobacco smoke exposure in children, although they did prevent smoking relapse among mothers during their postpartum period.

“This review is the first to specifically examine the effectiveness of child tobacco smoke exposure reduction interventions when delivered by health care professionals who provide routine child health care,” Justine B. Daly, MMedSci, at Hunter New England Local Health District in Australia, and colleagues wrote. “However, the recent Cochrane review determined that the efficacy of such interventions has not been clearly established across a range of outcomes, but found a small but significant intervention effect on parent-reported child tobacco smoke exposure. Similarly, a 2014 meta-analysis of 30 trials reported no significant intervention effects.”

Approximately 40% of children worldwide are exposed to secondhand smoke and are at increased risk for respiratory infections, ear infections, meningococcal disease, asthma and sudden infant death syndrome, according to the researchers. In addition, emerging evidence has shown that children may be at further risk from toxic residue on indoor surfaces attributed to secondhand smoke.

Daly and colleagues assessed 16 studies that met selection criteria and were published through June. The primary outcome was reduction in total smoking exposure in children, while secondary outcomes were smoking reduction or cessation in parents and prevention of smoking relapse in postpartum mothers. Two of the researchers independently extracted details of each study. If the researchers’ outcomes were similar, the study was included in the meta-analysis. If the researchers did not similarly describe the outcomes, narrative analysis was performed.

Narrative analysis of six studies that measured tobacco smoke exposure in children showed no effect by the interventions. The meta-analysis of nine studies that measured smoking cessation in parents also showed no intervention effect.

According to the researchers, this lack of effect may have been due to the underuse of nicotine therapy and difficulty in determining adherence of health care professionals to intervention protocols.

The meta-analysis of three studies, however, that measured prevention of smoking relapse in postpartum mothers (n = 1,293) showed a significant effect by interventions (RR = 1.53; 95% CI, 1.1-2.14).

“Evidence of intervention effectiveness in reducing postpartum relapse is important given that approximately two-thirds of women who quit smoking for pregnancy will relapse,” Daly and colleagues wrote. “There is potentially a substantial public health benefit if child health care professionals routinely identify mothers who have quit for pregnancy and provide them with support to remain smoke free.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.