Systematic review of controlled trials of interventions to promote smoke alarms

Aims-To evaluate the effects of promotion of residential smoke alarms. Methods-Electronic databases, conference proceedings, and bibliographies we re systematically searched, and investigators and organisations were contac ted, in order to identify controlled trials evaluating interventions design ed to promote residential smoke alarms. The following were assessed: smoke alarm acquisition, ownership, and function; fires; burns; and fire related injuries. Odds ratios (OR) were estimated by meta analysis of randomised tr ials. Results-A total of 26 trials were identified, of which 13 were randomised. Overall, counselling and educational interventions had only a modest effect on the likelihood of owning an alarm (OR = 1.26; 95% confidence interval ( CI): 0.87 to 1.81) or having a functional alarm (OR = 1.19; 95% CI: 0.85 to 1.66). Counselling as part of primary care child health surveillance had g reater effects on ownership (OR = 1.93; 95% CI: 1.04 to 3.58) and function (OR = 1.72; 95% CI: 0.78 to 3.78). Results were sensitive to trial quality, however, and effects on fire related injuries were not reported. In two no n-randomised trials, direct provision of free alarms significantly increase d functioning alarms and reduced fire related injuries. Media and community education showed little benefit in non-randomised trials. Conclusion-Counselling as part of child health surveillance may increase sm oke alarm ownership and function, but its effects on injuries are unevaluat ed. Community smoke alarm give away programmes apparently reduce fire relat ed injuries, but these trials were not randomised and results must be inter preted cautiously. Further efforts to promote smoke alarms in primary care or through give away programmes should be evaluated by adequately designed randomised controlled trials measuring injury outcomes.