ABSTRACT
Abstract .................................................................................................................. 146 9.1 Introduction................................................................................................... 146 9.2 Reducing Children’s ETS Exposure ............................................................ 147
9.2.1 Theory............................................................................................... 147 9.2.2 Policy and Regulations of ETS in Public Buildings ....................... 149 9.2.3 Airflow, ETS Markers, and Exposure Complexities........................ 150 9.2.4 Bans in Public Buildings Might Generalize to Residences............. 151 9.2.5 Policing Residential Bans................................................................. 152 9.2.6 Clinical Services for ETS Exposure Reduction............................... 153 9.2.7 Minimal Interventions and SLT ....................................................... 158 9.2.8 Clinician Compliance ....................................................................... 160 9.2.9 SLT-Based Counseling ..................................................................... 161 9.2.10 Effects Size, Clinical, and Public Health Significance.................... 162
9.3 Measures as Prerequisite for Both Detecting and Effecting ETS Exposure.. 163 9.3.1 Reactivity .......................................................................................... 164 9.3.2 No “Gold Standard” ......................................................................... 165 9.3.3 Acute vs. Cumulative Exposure ....................................................... 165 9.3.4 Real-Time and Continuous Measures .............................................. 165 9.3.5 Feedback ........................................................................................... 166
9.4 Discussion and New Research ..................................................................... 166 9.4.1 Reducing ETS Exposure .................................................................. 166 9.4.2 Improved Measures and Increased Intervention Effects.................. 167 9.4.3 New Intervention Approaches .......................................................... 168
9.5 Conclusion .................................................................................................... 170 Acknowledgments.................................................................................................. 171 References.............................................................................................................. 171
This chapter summarizes issues and empirical evidence for the reduction of children’s residential environmental tobacco smoke (ETS) exposure. Interventions designed for residential/child ETS exposure control have included policy, minimal clinical advice, and counseling services. Divorce court and adoption services have limited custody to protect children from ETS exposure. Controlled trials of clinicians’ one-time counseling services have generally shown null results. One-time minimal interventions appear ineffective, but large-scale studies may be warranted to determine possible minimal effects from which substantive public health benefits might be derived. Four trials found that repeated counseling/shaping procedures based on Social Learning Theory reduced children’s ETS exposure. Insufficient numbers of controlled studies of repeated session counseling procedures have been completed to determine efficacy for ETS exposure reduction, but evidence is promising and ongoing trials will add to the empirical evidence in the next few years. Measurement issues and their use for both assessment and intervention purposes are discussed. Suggestions for future research concerning ETS exposure and means of reducing exposure are provided.
