***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED Exposure to second-h and smoke ( SHS ) is a major public health problem and a risk factor for morbidity and mortality . The objective of this r and omized trial was to estimate the impact of a culturally-sensitive intervention to reduce SHS exposure in Mexican-American households . METHOD A total of 91 households ( with a child under 18 years of age and two adults , one of whom was a smoker ) were recruited from a population -based cohort of Mexican-American households and r and omized to receive the experimental intervention  ( EI ; n=47 ) or st and ard care ( SC ; n=44 ) . Of these , 74 households ( 83 % ) provided baseline , 6-month , and 12-month survey and nicotine monitor data ( EI , n=39 ; SC , n=35 ) . The EI material s , design ed to increase the participants ' likelihood of adopting a smoke-free indoor home air policy , included one culturally-appropriate bilingual comic book for children and two fotonovelas for adults . RESULTS Ambient nicotine levels significantly decreased over the 12 study months ( F=13.6 , DF=147 ; p<0.001 ) ; with a significantly greater decrease in the EI households compared to the SC households ( F=4.1 , DF=72 ; p<0.05 ) . At 12 months , 73 % of EI households had banned smoking vs. 56 % of SC households . Ambient nicotine levels , measured using nicotine air sampling monitors , were significantly associated with self-reported SHS exposure at the 12-month follow-up . Knowledge of the health effects of SHS increased from baseline to 6 and 12 months in the EI condition but not in the SC condition ( F=6.0 , DF=238 ; p<0.01 ) , and smokers and quitters in the EI group reported an increased perception of health vulnerability compared to those in the SC group . CONCLUSION Our low-cost intervention impacted SHS-related knowledge and exposure among Mexican Americans . This culturally-appropriate intervention has the potential to decrease SHS-related health problems in the target population substantially OBJECTIVE This r and omized controlled trial tested the efficacy of parent-based behavioral counseling for reducing secondh and smoke exposure ( SHSe ) among children with cancer . It also examined predictors of smoking and SHSe outcomes . METHODS Participants were 135 parents or guardians of nonsmoking children with cancer , < 18 years , at least 30 days postdiagnosis , and living with at least one adult smoker . Parents were r and omized to either a st and ard care control group or an intervention consisting of six counseling sessions delivered over 3 months . Parent-reported smoking and child SHSe levels were obtained at baseline , 3 , 6 , 9 , and 12 months . Children provided urine sample s for cotinine analyses . RESULTS Reductions in parent-reported smoking and exposure were observed in both the intervention and control conditions . There was a significantly greater reduction in parent-reported smoking and child SHSe at 3 months for the intervention group compared with the control group . Child SHSe was significantly lower at 12 months relative to baseline in both groups . Children 's cotinine levels did not show significant change over time in either group . Exposure outcomes were influenced by the number of smokers at home , smoking status of the parent participating in the trial , and the child 's environment ( home versus hospital ) the day before the assessment . CONCLUSIONS Children 's SHSe can be reduced by advising parents to protect their child from SHSe , combined with routine reporting of their child 's exposure and cotinine testing , when delivered in the context of the pediatric cancer setting . More intensive interventions may be required to achieve greater reductions in SHSe OBJECTIVE To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke ( ETS ) for their children have a higher quit rate than 1 ) mothers receiving routine smoking cessation advice or 2 ) a control group . DESIGN R and omized , controlled trial . SETTING Primary care center in a large urban children 's hospital . INTERVENTION Four hundred seventy-nine mothers were r and omly assigned to a smoking cessation intervention either aim ed at their child 's health or their own health , or to a control group receiving safety information . OUTCOME MEASURES Smoking status , stage of change , cigarettes/day , location smoking occurred , and knowledge of ETS effects . RESULTS Complete data ( baseline and both follow-ups ) were available for 166 subjects . There was no impact of group assignment on the quit rate , cigarettes/day , or stage of change . The Child Health Group intervention had a sustained effect on location where smoking reportedly occurred ( usually outside ) and on improved knowledge of ETS effects . CONCLUSIONS Further research is needed to devise more effective methods of using the pediatric health care setting to influence adult smoking behaviors BACKGROUND Since most smoker parents of children with asthma are unable to quit , an alternative measure that would reduce their children 's exposure to environmental tobacco smoke ( ETS ) is to ban smoking in the home . METHODS Compared with 136 usual-care controls , 128 intervention-group parents recruited from South Australian pediatric hospital outpatient waiting rooms were given written and verbal feedback about their 1- to 11-year-old child 's urinary cotinine-to-creatinine level , information booklets , and two telephone calls encouraging a ban on smoking at home . RESULTS At 6 months , 49.2 % of the intervention group reported having banned smoking in the home compared with 41.9 % of controls , but the differential rate of change from baseline was not significant ( P = 0.40 ) . At follow-up , there were no significant differences between groups in the percentage reporting bans on smoking in the car , the mean reduction from baseline in total daily consumption or consumption in front of the child , children 's urinary cotinine level , or parental smoking cessation . CONCLUSIONS The intervention did not change parents ' propensity to create or maintain bans on smoking in their homes or otherwise change smoking habits to reduce their children 's exposure to ETS . More intensive interventions may be required to achieve change among low-income smoker parents of children with asthma We conducted a r and omized controlled trial to determine whether a home-based intervention program could reduce  infant passive smoking and lower respiratory illness . The intervention consisted of four nurse home visits during the first 6 months of life , design ed to assist families to reduce the infant 's exposure to tobacco smoke . Among the 121 infants of smoking mothers who completed the study , there was a significant difference in trend over the year between the intervention and the control groups in the amount of exposure to tobacco smoke ; infants in the intervention group were exposed to 5.9 fewer cigarettes per day at 12 months . There was no group difference in infant urine cotinine excretion . The prevalence of persistent lower respiratory symptoms was lower among intervention-group infants of smoking mothers whose head of household had no education beyond high school : intervention group , 14.6 % ; and controls , 34.0 % Children with asthma who are exposed to environmental tobacco smoke are at increased risk for adverse health consequences . An experimental design was used to evaluate a minimal-contact intervention aim ed at modifying parents ' smoking behavior in their homes . All subjects received counseling on the health effects of passive smoking and advice to quit smoking inside the home . Treatment subjects were also mailed the results of a  urine cotinine test on their child and a self-help manual . More treatment ( 35 % ) than control ( 17 % ) subjects reported smoking outside their homes at posttest ( and their children 's cotinine levels were lower ) , but this difference was not statistically significant OBJECTIVES To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke ( ETS ) for their children have a higher quit rate than mothers who received routine smoking cessation advice  , which focused on their own health , or a control group of mothers . SETTING Tertiary referral centre . METHODS R and omized control trial . A total of 363 mothers were r and omly assigned to a smoking cessation intervention either aim ed at their children 's health ( n = 111 ) or their own health ( n = 131 ) , or to a control group receiving no smoking cessation advice ( n = 121 ) . RESULTS Provision to mothers of both groups of health risks of tobacco smoke result ed in significantly higher rate of cessation of smoking and smoking location change than those of the control group , with child intervention group having significantly higher rate of cessation of smoking and smoking location change than those of the maternal intervention group ( P < 0.05 ) . Post-intervention knowledge scores differed significantly for all groups ; however , child intervention group was the only significantly better group than the others ( P < 0.05 ) . According to the multivariate analysis results , intervention grouping and presence of smoking friends were independent factors determining smoking cessation ( P < 0.05 ) . Intervention grouping , post-intervention knowledge , presence of other household members who smoked and family income were independent factors determining smoking location change ( P < 0.05 ) . Family income , intervention grouping and presence of smoking friends were significant independent factors influencing post-intervention knowledge ( P < 0.05 ) . CONCLUSION Discussion during short paediatric visits on effects of smoking on child 's or maternal health may result in a significant smoking cessation , smoking location change rate or knowledge change . Those who can not give up smoking usually change their location of smoking . Provision of information on effects of smoking on child 's health , rather than maternal , may result in more significant changes in behaviour or knowledge . Maternal education on smoking should include information on effects of smoking on both child 's and maternal health , but should be especially focused on child 's health An information programme on measures to prevent passive smoking by children , design ed for use during well‐child visits , was tested . A total of 443 consecutive families with one or two smoking parents , attending mother and child health centres in Oslo , Norway , were r and omly allocated to an intervention group ( n= 221 ) and a control group ( n= 222 ) . Eighty families ( 18 % ) dropped out during the study period . For the intervention group , the communication between the health visitor and the family was prolonged at one well‐child visit with a brief session on smoking , and the parents were given three brochures . The families in the control group received no information on smoking . Changes in practical measures to prevent passive smoking by the children ( e.g. no smoking indoors ) as well as changes in daily smoking and smoking quantity were assessed by parental reports . We found no significant differences between the groups with respect to change in smoking behaviour OBJECTIVES We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers . METHODS We conducted a r and omized controlled trial with 1-year follow-up among 274 low-income households containing a child aged 4 - 12 years who had asthma .  Community health workers provided in-home environmental assessment s , education , support for behavior change , and re sources . Participants were assigned to either a high-intensity group receiving 7 visits and a full set of re sources or a low-intensity group receiving a single visit and limited re sources . RESULTS The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality -of-life score ( P=.005 ) and asthma-related urgent health services use ( P=.026 ) . Asthma symptom days declined more in the high-intensity group , although the across-group difference did not reach statistical significance ( P=.138 ) . Participant actions to reduce triggers generally increased in the high-intensity group . The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were 189 - 721 dollars . CONCLUSIONS Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality -of-life score . Improvement was greater with a higher-intensity intervention BACKGROUND We evaluated the effectiveness of a transtheoretical model (TTM)-based passive smoking prevention programme developed to enhance passive smoking avoidance among pregnant women and women with young children in Taiwan . METHODS Subjects were pregnant women recruited from the obstetrics/gynaecology department and women with children younger than age 3 recruited from the paediatrics department of four hospitals in Taiwan . Participants were r and omly assigned to a group receiving a TTM-based intervention programme or a comparison group receiving routine care . The intervention programme consisted of educational material s and phone counselling . Baseline assessment and post-test data were collected from both groups using a self-reported question naire developed based on stages of change related to readiness for passive smoking avoidance . RESULTS Determinants of change , post-test scores of knowledge , experiential and behavioural processes and self-efficacy were significantly different between the intervention group and comparison group among both pregnant women and mothers . Among pregnant women , the intervention group had significantly higher post-test scores than the comparison group . The distribution of percentages in three stages of change ( Precontemplation , Contemplation/Preparation and Action/Maintenance ) was significantly different between the two groups among both pregnant women and mothers . However , a higher percentage of mothers made progress in stages of change compared with pregnant women . CONCLUSION A TTM-based intervention programme was potentially effective in passive smoking prevention by improving knowledge , experiential and behavioural processes and self-efficacy among pregnant women and women with young children . A higher percentage of mothers with young children had progressed in stages of change post-intervention compared with pregnant women The overwhelming evidence about the role lifestyle plays in mortality , morbidity , and 
    Output:
    
: Interventions to prevent child TSE are moderately beneficial at the individual level .
Widespread child TSE suggests potential for significant population impact .