An Unsuccessful Cotinine-Assisted Intervention Strategy to Reduce Environmental Tobacco Smoke Exposure During Infancy

doi:10.1001/archpedi.1992.02160150097031

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Vol. 146 No. 3, March 1992

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An Unsuccessful Cotinine-Assisted Intervention Strategy to Reduce Environmental Tobacco Smoke Exposure During Infancy

Barbara A. Chilmonczyk, MD; Glenn E. Palomaki; George J. Knight, PhD; Josephine Williams; James E. Haddow, MD

Am J Dis Child. 1992;146(3):357-360.

Abstract

• Objective.
—To test a low-intensity physician's office—basedintervention strategy using infant urine cotinine measurements,aimed at reducing infant exposure to environmental tobacco smoke.

Design.
—A randomized intervention trial.

Setting.
—Offices of 28 physicians (pediatricians and family practitioners)and two hospital-based clinics in the Greater Portland, Me,area.

Participants.
—Infants brought to the physician by a parent (usuallythe mother) for an initial well-child visit. A total of 518of these infants and their mothers consented to provide informationabout household smoking habits and to provide a sample of theinfant's urine for biochemical analysis.

Selection Procedure.
—From among the consecutive sample of 518 enrolled mother/infantpairs, 103 mothers reported that they smoked 10 or more cigarettesper day, and these were randomized on an individual basis forintervention (52 pairs) or control (51 pairs). Randomizationtook place at the study center when the infant's urine sampleand information about household smoking habits were received.

Intervention.
—The physician telephoned the mother to report the urinecotinine result and to explain its meaning. The physician thensigned and sent an individualized form letter to the mother,providing specific recommendations for changing household smokinghabits.

Results.
—Follow-up urine cotinine measurements were obtained in27 (52%) of 52 infants from the intervention group and in 29(57%) of the 51 controls 2 months later. The mean log ratioof the follow-up to initial urine cotinine measurements was6% lower in the intervention group than in the control group.This difference was not statistically significant.

Conclusion.
—The low-intensity intervention strategy did not significantlyinfluence infant exposure to environmental tobacco smoke inthe household.

(AJDC. 1992;146:357-360)

Author Affiliations

From the Division of Biometry (Mr Palomaki and Mrs Williams), the Prenatal Screening Laboratory (Drs Knight and Haddow), and Clinical Immunology (Dr Chilmonczyk), Foundation for Blood Research, Scarborough, Me.

Footnotes

Accepted for publication October 7, 1991.

Reprint requests to the Foundation for Blood Research, PO Box190, Scarborough, ME 04070-0190 (Dr Haddow).

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