WIC Families Who Smoke: A Behavioral Counseling Study
Project Number: R40 MC 02494-04 Project Date: 01/01/2000 Grantee: San Diego State University Foundation Department/Center: Graduate School of Public Health
Melbourne Hovell Ph.D., Professor, San Diego State University Foundation Graduate School of Public Health, 9245 Sky Park Court, Suite 230 San Diego, CA 92123 mhovell@projects.sdsu.edu
Abstract
This is a competing continuation proposal to complete a trial testing a behavioral intervention designed to reduce environmental tobacco smoke exposure (ETS) and parents' smoking among 150 low-income families recruited from WIC. Primary Aims: 1) to determine the effects of the counseling program on young children's ETS exposure; 2) to determine the effects of participation on mothers' level of smoking and proportion who quit smoking; 3) to validate parent-reported ETS exposure using urine cotinine assays and environmental nicotine monitors. Secondary aims: 4) to determine the effects of participation on other parents' and other smokers' level of smoking and proportion of quits; 5) to explore health outcome measures; 6) to identify possible determinants of ETS exposure and smoking cessation; 7) to examine patterns in repeated baseline children's urine cotinine values; 8) to explore the cost effectiveness of the intervention. This study is an extension of our previous research and combines behavioral counseling for ETS reduction and smoking cessation with nicotine replacement therapy. After 3 baselines, families are assigned at random to the experimental counseling or "usual care" control condition. The experimental group receives 14 counseling sessions over 6 months. Primary participants are mothers, but other parents and other smokers living in the home are encouraged to participate. Counseling incorporates behavioral contracting, shaping, and problem-solving negotiations. Measures are obtained at 3 baselines, 3, 6, 12, and 18 months; and include a detailed interview concerning smoking and exposure rates, key Social Learning Theory variables, and children's health, children's urine samples for cotinine analysis, and environmental nicotine. Self-reported smoking cessation is verified with saliva cotinine or anabasine/anatabine analysis. If effective, the intervention could be incorporated into standard care at WIC clinics nationwide as well as in other settings.
Publications
Listed is descending order by year published.
Matt GE, Hovell MF, Quintana PJE, Zakarian JM, Liles S, Meltzer SB, Benowitz NL. The variability of urine cotinine levels in young children: Implications for measuring ETS exposure. Nicotine & Tobacco Research 2007; 9(1):83-92.
Matt GE, Quintana PJE, Liles S, Hovell MF, Zakarian JM, Jacob P, Benowitz NL. Evaluation of urinary trans-3'-hydroxycotinine as a biomarker of children's environmental tobacco smoke exposure. Biomarkers 2006; 11(6):507-523.
Gehrman CA, Hovell MF. Protecting children from ETS exposure: A critical review. Nicotine & Tobacco Research 2003; 5:289-301.
