Real-time feedback of air quality in children's bedrooms reduces exposure to secondhand smoke

Vincent Berardi; Bradley N Collins; Laura M Glynn; Stephen J Lepore; E Melinda Mahabee-Gittens; Karen M Wilson; Melbourne F Hovell

doi:10.18332/tpc/149908

Real-time feedback of air quality in children's bedrooms reduces exposure to secondhand smoke

Tob Prev Cessat. 2022 Jun 22:8:23. doi: 10.18332/tpc/149908. eCollection 2022.

Authors

Vincent Berardi¹, Bradley N Collins², Laura M Glynn¹, Stephen J Lepore², E Melinda Mahabee-Gittens³, Karen M Wilson⁴, Melbourne F Hovell⁵

Affiliations

¹ Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, Orange, United States.
² Department of Social and Behavioral Sciences, Temple University, Philadelphia, United States.
³ Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States.
⁴ University of Rochester Medical Center, Rochester, United States.
⁵ San Diego State University Graduate School of Public Health, San Diego, United States.

Abstract

Introduction: Secondhand smoke (SHS) exposure creates health risks for non-smokers and is especially detrimental to children. This study evaluated whether immediate feedback in response to poor indoor air quality in children's bedrooms can reduce the potential for SHS exposure, as measured by adherence to a World Health Organization (WHO) indoor air standard.

Methods: Homes that contained children and an adult who regularly smoked inside (n=298) had an air particle monitor installed in the child's bedroom. These devices measured the concentration of particulate matter (PM2.5) for approximately three months and, for half of the participants, immediately provided aversive feedback in response to elevated PM2.5. Hierarchical linear models were fit to the data to assess whether the intervention increased the probability that: 1) a given day was below the WHO guideline for daily exposure, and 2) a household established and maintained a smoke-free home (SFH), operationalized as achieving 30 consecutive days below the WHO guideline. The intervention's impact was calculated as group-by-time effects.

Results: The likelihood that a child's bedroom met the WHO indoor air quality standard on a given day increased such that the baseline versus post-baseline odds ratio (OR) of maintaining indoor PM2.5 levels below the WHO guideline was 2.38 times larger for participants who received the intervention. Similarly, the baseline versus post-baseline OR associated with achieving an SFH was 3.49 times larger for participants in the intervention group.

Conclusions: The real-time intervention successfully drove clinically meaningful changes in smoking behavior that mitigated indoor PM2.5 levels in children's bedrooms and thereby reduced SHS exposure. These results demonstrate the effectiveness of targeting sensitive microenvironments by giving caregivers actionable information about children's SHS risks. Future extensions should examine additional microenvironments and focus on identifying the potential for SHS exposure before it occurs.

Keywords: air monitoring; air quality; in-home smoking; secondhand smoke; smoke-free environments; youth.