Radon-smoking synergy: A population-based behavioral risk reduction approach

Background Radon and cigarette smoking have a synergistic, multiplicative e ffect on lung cancer rates. Smokers, and perhaps nonsmoking residents, of s moking households are at increased risk far lung cancer even when radon lev els are relatively low. A behavioral risk reduction strategy emphasizing sm oking cessation is proposed and data are presented from pilot studies and a short-term evaluation of a randomized intervention trial. Methods, Pilot studies, including radon testing interviews, questionnaires, and focus groups, led to a three-arm randomized intervention trial compari ng two kinds of written materials and telephone counseling. Smoking househo lds were recruited by offering free radon test kits through an electric uti lity companies billing system, Three-month follow-up data were obtained by mail and phone. Results Of an estimated 2,600 smoking households in the utility district, 1 ,220 requested a radon test bit, and 714 were randomized into three treatme nt conditions. Brief phone counseling (up to two short calls) significantly increased smoking quit rates, compared to written materials only, and was also related to other risk reduction behaviors (e.g., household, ban on smo king), Conclusions. Offering free radon testing through a public utility billing s ystem is an effective recruitment tool for reaching households at risk due to radon-smoking synergy. Brief telephone counseling is superior to written materials in reducing smoking and encouraging indoor smoking bans. Methods are needed to better inform smokers of their additional risk from exposure to even low levels of radon. (C) 1999 American Health. Foundation and Acad emic Press.