This annual report - Taranaki District Health Board

Local Policy Documents and Evidence-Based Reviews Relevant tothe Prevention of Second-Hand Cigarette Smoke Exposure inChildrenIn New Zealand, there is no national strategy focussed on the prevention of second-hand cigaretteexposure in children. Any local strategies developed will thus need to incorporate evidence from avariety of sources. Table 39 (below) provides an overview of a range of New Zealand policydocuments and evidence-based reviews which may be useful in this context. In addition, Table 34(Page 197) provides an overview of publications relevant to the cessation of smoking inpregnancy, and Table 42 (Page 219) and Table 43 (Page 222) address the prevention andcessation of smoking in young people.Table 39. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention ofExposure to Second-Hand Cigarette Smoke in ChildrenMinistry of Health Policy DocumentsMinistry of Health. 2007. New Zealand Smoking Cessation Guidelines. Wellington: Ministry of Health.http://www.health.govt.nz/publication/new-zealand-smoking-cessation-guidelinesThe smoking cessation guidelines recommend that all health workers should be aware of the risks of second-handsmoke to children and young people exposed to smoking in their families and homes. Brief advice and cessation supportto should be offered to all family members who smoke.Ministry of Health. 2010. Well Child/Tamariki Ora National Schedule: Four to six weeks, to five years. Wellington:Ministry of Health.Ministry of Health. 2010. Well Child/Tamariki Ora National Schedule: Birth, to four to six weeks. Wellington: Ministryof Health.http://www.health.govt.nz/our-work/life-stages/child-health/well-child-services/well-child-publications/well-child-nationalscheduleThe Well child/Tamariki Ora schedule outlines the assessment, intervention, and health education activities for each ofthe Lead Maternity Carer postnatal contacts, the GP six week visit and the eight universal core contacts delivered in theWell Child programme, to children aged between four to six weeks, and five years and their families. ABC smokingcessation advice, as described in the New Zealand Smoking Cessation Guidelines, is recommended at each contact.Cochrane Systematic ReviewsPriest N, et al. 2008. Family and carer smoking control programmes for reducing children's exposure toenvironmental tobacco smoke. Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD001746.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001746/frame.htmlThis review examined the effectiveness of interventions aimed at reducing environmental smoke exposure in children.Thirty-six controlled trials were included, 30 of which random allocation. The majority of trials targeted parents in ‘wellchild’or ‘ill-child’ healthcare settings, and including educational and counselling interventions. There was insufficientevidence to clearly demonstrate the effectiveness a particular intervention. Eleven studies identified a statisticallysignificant effect of the intervention on children’s smoke exposure, four of which delivered intensive counselling inhealthcare settings.Other Systematic ReviewsRosen LJ, et al. 2012. Parental Smoking Cessation to Protect Young Children: A Systematic Review and Metaanalysis.Pediatrics, 129(1), 141-52.This recent systematic review of interventions aimed at parental smoking cessation identified 18 controlled trials (7053participants). Interventions included self-help, counselling and medication and took place in a range of settings. Metaanalysisrevealed a significant improvement in overall quit rates for intervention groups compared to controls (RR 1.34,95% CI 1.05 to 1.71) and a risk difference of 0.04 (95% CI 0.01 to 0.07), suggesting that an additional 4% of parents inthe intervention groups stopped smoking. The subgroups with significantly increased quit rates were those with childrenaged 4 to 17 years, interventions whose primary goal was cessation, interventions that offered medications andinterventions with high follow-up rates (over 80%). While interventions significantly increased quit rates the authors notethat the majority of parents continued to smoke, necessitating additional strategies.Note: The publications listed above were identified using the search methodology outlined in Appendix 1Second-hand Cigarette Smoke Exposure - 211