TY - JOUR T1 - Effectiveness of a brief primary care intervention to reduce passive smoking in babies: a cluster randomised clinical trial JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 249 LP - 260 DO - 10.1136/jech-2014-204708 VL - 69 IS - 3 AU - Guadalupe Ortega Cuelva AU - Carmen Cabezas Peña AU - Jesús Almeda Ortega AU - Marc Saez Zafra AU - Jose L Ballvé Moreno AU - Jose A Pascual Esteban AU - Cristina Castellà Cuesta AU - Carlos Martín-Cantera AU - Esteve Saltó Cerezuela AU - Rosa M Casademont Pou AU - Estela Díaz Alvarez AU - Joan Lozano Fernandez AU - Concepció Morera Jordán AU - Araceli Valverde Trillo AU - Raúl Pérez-Ortuño AU - Lourdes Rofes Ponce AU - Mireia Jané Checa AU - The BIBE study group Y1 - 2015/03/01 UR - http://jech.bmj.com/content/69/3/249.abstract N2 - Background Tobacco smoke pollution (TSP) has major negative effects on infant health. Our objectives were to determine the effectiveness of a brief primary care intervention directed at parents who smoke in reducing babies’ TSP exposure, and to establish variables related to greater exposure. Method A multicentre, open, cluster-randomised clinical trial in Catalonia. The 83 participating primary health paediatric teams of the Catalan Health Service recruited 1101 babies whose parents were smokers. The intervention group (IG) received a brief TSP intervention; the control group (CG) received the usual care. Outcomes were measured by parents’ reported strategies to avoid TSP exposure. Baseline clinical data and characteristics of each baby's TSP exposure were collected, along with infant hair samples and parents’ tobacco use and related attitudes/behaviours. At 3-month and 6-month follow-up, behavioural changes to avoid TSP exposure were recorded; the association between reported parental behaviours and nicotine concentration in infant hair samples was tested in a random sample of 253 babies at baseline and 6 months. Results During follow-up, TSP-avoidance strategies improved more in the IG than in the CG: 35.4% and 26.9% ( p=0.006) at home, and 62.2% and 53.1% in cars (p=0.008). Logistic regression showed adjusted ORs for appropriate measures in the IG versus CG of 1.59 (95% CI 1.21 to 2.09) at home and 1.30 (95% CI 0.97 to 1.75) in cars. Hair samples showed that 78.7% of the babies tested were exposed. Reduced nicotine concentration was associated with improved implementation of effective strategies reported by parents at home (p=0.029) and in cars (p=0.014). Conclusions The intervention produced behavioural changes to avoid TSP exposure in babies. The proportion of babies with nicotine (>=1ng/mg) in hair samples at baseline is a concern. Trial registration number Clinical Trials.gov Identifier: NCT00788996. ER -