How to prevent exposure to tobacco smoke among small children: a literature review

There are many reviews of current knowledge about smoking cessation in gene ral within the health service, which also contain guidelines about smoking cessation during pregnancy. Our aim was to review methods in child healthca re for preventing the exposure of children to tobacco smoke. Since passive smoking starts during pregnancy, we also considered methods in antenatal ca re. We did a search for relevant articles, especially on randomized, contro lled trials, in various databases, chiefly Medline. We mainly analysed stud ies from the last 10 y, concentrating on the actual interventions. In anten atal care the greatest effect comes from interventions based on behavioural strategies. These can lead to a doubling of the number of women who stop s moking during pregnancy. Purely factual information, on the other hand, has no great effect. The studies in child healthcare analysed here show that decisive factors fo r children not being exposed to passive smoking are a concentration on stre ngthening the parents'; faith in their ability to create a smoke-free envir onment, and on behavioural strategies to achieve this goal, but not primari ly on getting the parents to stop smoking. However, We need further studies of different types of interventions, geared to smokers with Small children , before more specific recommendations can be given as to how child healthc are should design its tobacco-preventive work.