Plain English Summary
Background and study aims
Passive smoking represents a serious health hazard and is a substantial threat to child health increasing risk of acute respiratory illness in children. Nurses are in a vital position to conduct health education to improve children's health, which is a legitimate activity in a pediatric ward. This study assesses the effectiveness of nurses providing health education intervention to mothers of sick children aiming to prevent the children from exposure to secondhand smoke (SHS) and to help the fathers quit.
Who can participate?
The subjects are non-smoking mothers of sick children who admitted to the paediatric ward and with a smoking husband living in the same household. Sick children who were admitted to the hospital with other relatives (other than the mother) or maids were excluded from the study.
What does the study involve?
The non-smoking mothers are randomly assigned into two groups. One group (intervention group) the nurses provide mothers with a 3-mins standardized health advice on the health hazard of SHS exposure, one purpose-designed booklet to suggest mothers take actions to prevent SHS exposure of their sick children and other suggestions for them to encourage and assist their husbands stop smoking and a self-help smoking cessation booklet for mothers to bring back to their husband; and a telephone reminder to the mothers one week later. Another group (control group) only receives normal care provided by nurses, and there is no specific advice on secondhand smoke exposure during normal care. Both groups are contacted by nurse counselors at 3-, 6-, and 12-month by telephone for follow-up interviews.
What are the possible benefits and risks of participating?
There is no risk for mothers to participate the study. We will not provide incentives to participants, but we hope the mothers in the intervention group can have immediate direct benefit by reducing their children from SHS exposure and helping their husband stop smoking.
Where is the study run from?
This study is conducted by School of Nursing, The University of Hong Kong. Participants are recruited in the pediatric wards and outpatient departments of four major acute hospitals under the Hong Kong Hospital Authority: Queen Mary Hospital, Pamela Youde Nethersole Eastern Hospital, Kwong Wah Hospital and Yan Chai Hospital.
When is the study starting and how long is it expected to run for?
The recruitment of participant was started in November 1997 and completed in September 1998. The 12-month telephone interview ended in September 1999.
Who is funding the study?
Research Fund Secretariat, Food and Health Bureau, Hong Kong.
Who is the main contact?
Professor Sophia Chan
A randomised control trial (RCT) of a nurse-led brief advice to mothers of sick children in preventing household secondhand smoke exposure and encouraging fathers to quit smoking in Hong Kong
Brief advice provided by nurses to mothers of sick children could be effective in improving household secondhand smoke exposure (SHS) and indirectly encouraging fathers to quit smoking.
Ethics Committee of the Faculty of Medicine, University of Hong Kong, September 1997, ref: EC-150
Prospective multi-centred single-blinded two-armed randomized controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Sick children in the paediatric wards / outpatient departments, with non-smoking mothers and smoking fathers
The intervention group received a health education intervention provided by nurses, which included:
1. Giving standardised health advice
2. Two purpose-designed health education booklets (SHS booklet for the mother and Quit Smoking booklet for the father
3. A purpose-designed sticker
4. A telephone reminder one week later
No intervention was given to the control group except the normal care provided by nurses. No advice on SHS was given during normal care.
Primary outcome measure
The 7-day point-prevalence quit rate of the child' s father proxy reported by spouse at 12-month follow-up
Secondary outcome measures
1. The 7-day point-prevalence quit rate of the child' s father at 3- and 6-month follow-up proxy reported by spouse
2. The mother's behavior in protecting the child from exposure to SHS, such as moving the child away from the smoking fathers and /or other smokers
3. Change in the smoking habits of the child's father such as reduction in smoking (in general, at home, and near the child)
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Non-smoking mothers who bring their sick child to the hospital
2. The child's father is a current smoker
3. Mother, father and child are living together in the same household
4. The mother speaks and reads Cantonese Chinese
Target number of participants
Participant exclusion criteria
Sick children who were admitted to the hospital with other relatives (other than the mother) or with maids
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
4/F William MW Mong Block
Food and Health Bureau (Hong Kong)
Research Fund Secretariat
Health Services Research Fund, Hong Kong SAR Government (Hong Kong) ref: HSRC 611004
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
2003 results in http://www.ncbi.nlm.nih.gov/pubmed/14702863
2006 results in http://www.ncbi.nlm.nih.gov/pubmed/16671973
2008 results in http://www.ncbi.nlm.nih.gov/pubmed/18785372
2013 results in http://www.ncbi.nlm.nih.gov/pubmed/23565835
Chan S, Lam TH, Preventing exposure to second-hand smoke., Semin Oncol Nurs, 2003, 19, 4, 284-290.
Chan S, Lam TH, Protecting sick children from exposure to passive smoking through mothers' actions: a randomized controlled trial of a nursing intervention., J Adv Nurs, 2006, 54, 4, 440-449, doi: 10.1111/j.1365-2648.2006.03842.x.
Chan SS, Leung GM, Wong DC, Lam TH, Helping Chinese fathers quit smoking through educating their nonsmoking spouses: a randomized controlled trial., Am J Health Promot, 23, 1, 31-34, doi: 10.4278/ajhp.07043040.
Chan SS, Wong DC, Lam TH, Will mothers of sick children help their husbands to stop smoking after receiving a brief intervention from nurses? Secondary analysis of a randomised controlled trial., BMC Pediatr, 2013, 13, 50, doi: 10.1186/1471-2431-13-50.