Cochrane Summaries

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Can interventions for parents and people caring for children reduce children's exposure to tobacco smoke

Baxi R, Sharma M, Roseby R, Polnay A, Priest N, Waters E, Spencer N, Webster P
Published Online: 
1 March 2014


Children exposed to cigarette smoke (environmental tobacco smoke) are at greater risk of lung problems, infections and serious complications including sudden infant death syndrome. Preventing exposure to cigarette smoke in infancy and childhood might therefore significantly improve children's health worldwide. Parental smoking is a common source of cigarette exposure for children. Older children are also at risk of exposure to cigarette smoke in child care or educational settings.


To determine the effectiveness of interventions aiming to reduce exposure of children to tobacco smoke.


A review of the research on the effect of interventions aimed at family and caregivers to reduce children’s exposure to tobacco smoke was undertaken by researchers in the Cochrane Collaboration. Family and caregivers were defined as parents and other family members, child care workers and teachers involved with the care and education of infants and young children (aged 0 to 12 years). We searched a number of databases for relevant research. This was an update of a previously undertaken review, and the date of the most recent search was September 2013. Two authors independently assessed the research studies and documented all the information needed.


Fifty-seven studies of mixed quality were included in this review. Only 14 studies reported an intervention that was successful at reducing children’s exposure to tobacco smoke. These studies used a range of interventions, including seven that used more intensive counselling methods or motivational interviewing. Of the 42 studies that did not show a significant reduction in child tobacco smoke exposure, 14 used more intensive counselling methods or motivational interviewing. One study did not aim to reduce children's tobacco smoke exposure, but reduce symptoms of asthma, and successfully reduced symptoms using motivational interviewing.

Authors' conclusions

Although several interventions, including parental education and counselling programmes, have been used to try to reduce children's tobacco smoke exposure, their effectiveness has not been clearly demonstrated. The review was unable to determine if any particular interventions reduced parental smoking and child smoke exposure more effectively than others, although seven studies were identified that reported intensive counselling or motivational interviewing provided in clinical settings was effective.

This record should be cited as: 
Baxi R, Sharma M, Roseby R, Polnay A, Priest N, Waters E, Spencer N, Webster P. Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke. Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No.: CD001746. DOI: 10.1002/14651858.CD001746.pub3
Assessed as up to date: 
20 February 2014