Children Learning About Second-hand Smoke (CLASS II): A pilot cluster randomised controlled trial

儿童了解二手烟（II 级）：一项试点整群随机对照试验

• 批准号: MR/M020533/1
• 负责人: Kamran Siddiqi
• 金额: $ 19.07万
• 依托单位: University of York
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2015
• 资助国家: 英国
• 起止时间: 2015 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FM020533%2F1
• 关键词: Children; Learning; About; Second; hand

Breathing in other people's smoke is called passive smoking; also sometimes referred to as involuntary or second-hand smoking (SHS). Second-hand smoke contains 4000 chemicals, 70 of which can cause cancer. SHS is particularly harmful to children's health and can lead to chest and ear infections, tuberculosis, meningitis and asthma. It is also associated with lung cancer and heart disease. Globally, 40% of children are exposed to SHS. Many countries have introduced bans on smoking in enclosed public spaces, which has significantly reduced adults' exposure to SHS. However, for the majority of children, cars and homes remain the most likely places for them to breathe in SHS. The only possible way to protect children from SHS is to make cars and homes completely smoke free. For the last three years, we have been working with teachers, children and their parents in primary schools in Dhaka, Bangladesh to develop and test an intervention called, 'Smoke Free Homes'. It consists of six teaching lessons delivered by schoolteachers, four fun activities and one educational take home resource. Teaching lessons help to increase pupils' knowledge about the harms caused by breathing in other people's smoke. Fun activities include storytelling, role-playing, quizzes and games. These activities help to motivate children to act and feel confident in talking to adults to persuade them not to smoke inside homes. The take-home resource helps children to show what they have learned in school and to negotiate with their families to "sign-up" to a voluntary contract to make their homes smoke-free. The results of this work show that it is possible to encourage children to discuss with their families ways of restricting smoking inside their homes. Inspired by what we found, we now wish to plan for a large study where we randomly select half of the schools to either have 'Smoke Free Homes' and half not to have it (but to receive it at the end of the study). We wish to examine how effective 'Smoke Free Homes' is in reducing children's exposure to SHS. We are also interested to see if the intervention improves their lung health, general quality of life, school attendance and school performance. We would also like to examine if it helps in changing their attitude towards smoking and makes it less likely for them to take up smoking in future. To provide accurate answers to these important questions, we will need to recruit many schools and possibly thousands of children. We will also need to use objective measurements including testing children's saliva for cotinine - a chemical derivative of nicotine found in those who are exposed to SHS. Other measures will include breathing tests to assess children's lung capacities and volumes, questionnaires and diaries to be kept by children to record their symptoms such as cough, wheeze and scales to measure school performance and attitudes to smoking. Before carrying out this large study, we plan to conduct a pilot study. This pilot study will simulate the large study but will be conducted on a smaller scale. The information obtained from the pilot study will help us to carefully plan for the large study and help us to test our assumptions. These include the number of schools and children to be recruited, feasibility and acceptability of the specified measurements and resource requirement for scaling up the intervention. We are proposing to conduct this pilot study in Dhaka Division, Bangladesh. We will recruit a total of 12 primary schools and 360, year 5 (10-12 years old) children. We will undertake all the measurements as described above using internationally agreed standards and measures. Once measurements have been taken, half of the schools will be randomly chosen to receive 'Smoke Free Homes' while the other half will not receive the intervention until the end. We will repeat the assessments at two, six and twelve months after the intervention. Findings will help us to plan for the large study.

吸入别人的烟雾称为被动吸烟；有时也称为非自愿吸烟或二手吸烟 (SHS)。二手烟含有 4000 种化学物质，其中 70 种可致癌。二手烟对儿童健康尤其有害，可导致胸部和耳朵感染、肺结核、脑膜炎和哮喘。它还与肺癌和心脏病有关。全球 40% 的儿童接触过二手烟。许多国家都禁止在封闭的公共场所吸烟，这大大减少了成年人接触二手烟的机会。然而，对于大多数儿童来说，汽车和房屋仍然是他们最有可能吸入二手烟的地方。保护儿童免受二手烟侵害的唯一可能方法是让汽车和家庭完全无烟。在过去的三年里，我们一直与孟加拉国达卡小学的教师、儿童及其家长合作，开发和测试名为“无烟之家”的干预措施。它包括由学校教师讲授的六节教学课程、四项有趣的活动和一项带回家的教育资源。教学课程有助于增加学生对吸入他人烟雾所造成危害的了解。有趣的活动包括讲故事、角色扮演、测验和游戏。这些活动有助于激励儿童采取行动，并有信心与成年人交谈，说服他们不要在家里吸烟。带回家的资源可以帮助孩子们展示他们在学校学到的知识，并与家人协商“签署”自愿合同，使他们的家成为无烟区。这项工作的结果表明，鼓励孩子与家人讨论限制在家中吸烟的方法是可能的。受我们发现的启发，我们现在希望计划进行一项大型研究，随机选择一半学校拥有“无烟之家”，另一半学校不拥有（但在研究结束时接收）。我们希望研究“无烟之家”在减少儿童接触二手烟方面的效果如何。我们也有兴趣了解干预措施是否可以改善他们的肺部健康、总体生活质量、学校出勤率和学习成绩。我们还想研究一下它是否有助于改变他们对吸烟的态度并降低他们将来吸烟的可能性。为了准确回答这些重要问题，我们需要招募许多学校，甚至可能招募数千名儿童。我们还需要使用客观的测量方法，包括测试儿童唾液中的可替宁——一种尼古丁的化学衍生物，存在于接触二手烟的人身上。其他措施包括评估儿童肺活量和肺容量的呼吸测试、儿童填写问卷和日记以记录咳嗽、喘息等症状，以及衡量学校表现和对吸烟态度的量表。在进行这项大型研究之前，我们计划进行一项试点研究。该试点研究将模拟大型研究，但将以较小规模进行。从试点研究中获得的信息将帮助我们仔细规划大型研究并帮助我们检验我们的假设。其中包括要招募的学校和儿童的数量、特定测量的可行性和可接受性以及扩大干预措施的资源需求。我们提议在孟加拉国达卡专区进行这项试点研究。我们将总共招收12所小学和360名五年级（10-12岁）儿童。我们将使用国际商定的标准和措施进行上述所有测量。一旦进行测量，一半的学校将被随机选择接受“无烟之家”，而另一半学校直到最后才会接受干预。我们将在干预后的两个月、六个月和十二个月重复评估。研究结果将帮助我们规划大型研究。

项目成果

Secondhand Smoke Exposure in Primary School Children: A Survey in Dhaka, Bangladesh.

小学生的二手烟暴露：孟加拉国达卡的一项调查。

• DOI: 10.1093/ntr/ntx248
• 发表时间: 2019-03-30
• 期刊: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
• 作者: Shah S;Kanaan M;Huque R;Sheikh A;Dogar O;Thomson H;Parrott S;Siddiqi K
• 通讯作者: Siddiqi K

Children Learning About Secondhand Smoke (CLASS II): protocol of a pilot cluster randomised controlled trial.

• DOI: 10.1136/bmjopen-2015-008749
• 发表时间: 2015-08-25
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: Siddiqi K;Huque R;Jackson C;Parrott S;Dogar O;Shah S;Thomson H;Sheikh A
• 通讯作者: Sheikh A

Children Learning About Secondhand Smoke (CLASS II): A Pilot Cluster Randomized Controlled Trial.

儿童学习二手烟（II类）：试点群集随机对照试验。

• DOI: 10.1093/ntr/nty090
• 发表时间: 2019-04-17
• 期刊: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
• 作者: Siddiqi K;Huque R;Kanaan M;Ahmed F;Ferdous T;Shah S;Jackson C;Parrott S;Ahluwalia JS;Sheikh A
• 通讯作者: Sheikh A

Children Learning About Second-hand Smoke (CLASS II): a mixed methods process evaluation of a school-based intervention

儿童了解二手烟（第二类）：基于学校的干预措施的混合方法过程评估

• DOI: 10.21203/rs.2.24626/v1
• 发表时间: 2020
• 作者: Jackson C

Children Learning About Second-hand Smoke (CLASS II): a mixed methods process evaluation of a school-based intervention.

• DOI: 10.1186/s40814-021-00853-9
• 发表时间: 2021-05-24
• 期刊: Pilot and feasibility studies
• 影响因子: 1.7
• 作者: Jackson C;Huque R;Ahmed F;Nasreen S;Shah S;Ahluwalia JS;Kanaan M;Sheikh A;Siddiqi K
• 通讯作者: Siddiqi K