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Putting public health evidence into practice: increasing the prevalence of working smoke alarms in disadvantaged inner city housing
  1. H Roberts1,
  2. K Curtis1,
  3. K Liabo1,
  4. D Rowland2,
  5. C DiGuiseppi3,
  6. I Roberts2
  1. 1Child Health Research and Policy Unit, City University, London, UK
  2. 2Public Health Intervention Research Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, USA
  1. Correspondence to:
 Ms K Curtis
 Child Health Research and Policy Unit, Institute of Health Sciences, City University, 20 Bartholomew Close, London EC1A 7QN, UK;


Study objectives: The UK government recommends that local authorities install battery operated smoke alarms to prevent fire related injury. However, a randomised controlled trial of smoke alarm installation in local authority housing found a low level of working alarms at follow up. Qualitative work, which accompanied the trial explored barriers and levers to the use of this public health intervention.

Design: Semi-structured group and individual interviews were conducted with a sample of the adult participants in a randomised controlled trial of free smoke alarm installation. Group interviews and ”draw and write” exercises were conducted with children at a local primary school.

Participants: A sample of trial participants and primary school children in the trial neighbourhood.

Setting: An inner city housing estate in central London.

Main results: The main barrier to smoke alarm use was the distress caused by false alarms. Although trial participants considered themselves to be at high risk for fires and would recommend smoke alarms to others, respondents’ reports on the distress caused by false alarms suggest that people balance immediate and longer term risks to their health and wellbeing when they disable alarms.

Conclusions: This study identified some of the reasons for the low level of functioning smoke alarms, and problems experienced with alarms. The results have implications for the implementation of this public health intervention. The effectiveness of smoke alarm installation could be improved if alarm manufacturers and those responsible for implementation programmes considered ways of tackling the issues raised in this study.

  • public health implementation
  • smoke alarms

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  • * Overall ages, ethnicities, and other characteristics are provided in table 1. We asked those we interviewed to describe themselves, and some declined to provide age or ethnicity data. For this reason, not all respondents are described in the same way.

  • Funding: The UK Medical Research Council (ISRCTN 47572799); Camden and Islington Health Action Zone, the West Euston Partnership; and the Joan Dawkins Fund

  • Conflicts of interest: none declared.

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