REFERENCE: Wahlgren, D. R., Hovell, M.F., Meltzer, S. B., Hofstetter, C. R., Zakarian, J. M. (1997). Reduction of environmental tobacco smoke exposure in asthmatic children: A two-year follow-up. Chest, 111, 81-88.

Study objective -- To examine the long term maintenance of a previously-reported behavioral counseling intervention to reduce asthmatic children's exposure to environmental tobacco smoke (ETS).

Participants -- Families of asthmatic children (6-17 years), including at least one parent who smoked in the home, recruited from four pediatric allergy clinics.

Design -- Participants were randomized to one of three groups: behavioral counseling to reduce ETS exposure, self-monitoring control, and usual medical care control. Counseling concluded at month 6 and the original trial ended at month 12. Two follow-up interviews occurred at months 20 and 30.

Measurements and results -- The originally-reported analysis of baseline to 12 months was re-analyzed with a more robust restricted maximum likelihood procedure. The two-year follow-up period was analyzed similarly. Significantly greater change occurred in the counseling group than the controls, and was sustained throughout the two years of follow-up. Further exploratory analyses suggested that printed counseling materials given to all participants at month 12 (conclusion of the original study) were associated with decreased exposure in the control groups.

Conclusion -- Such long term maintenance of behavior change is highly unusual in the general behavioral science literature, let alone for addictive behaviors. We conclude that ETS can be reduced and that a clinician-delivered treatment may provide substantial benefit.

[Abstract and PDF available from the Chest website. This research was previously presented in part at the 123rd annual meeting of the American Public Health Association, San Diego, October 29 - November 2, 1995.]


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