Short-term (2-Month) Effects of a CHW-Delivered Intervention for Improving Smoking Hygiene Behaviors among Parents of Children under 5 in Rural China: A Mixed Method Study

Background: Secondhand smoke (SHS) exposure has direct adverse health impacts, especially among young children. With high prevalence of smoking in rural China, children were faced with severe SHS exposure within households. The aim of this study is to investigate short-term (2-month) effects of a community-based smoking hygiene intervention. Method: To adapt an evidence-based intervention packet, we interviewed residents of the target community via focus group discussion. Community health workers (CHWs) and village doctors (VDs) were trained as counsellors to implement the intervention. A follow-up assessment was conducted to compare the differences between subjects in the intervention and control group in regard to their smoking behavior and household smoking hygiene practices. Relevant health workers were interviewed to learn their experience of delivering the smoking hygiene intervention. Result: We found that the intervention had minor effects on smoking cessation among the subjects (7.7% vs 7.3%, P=0.91); while smokers who received the counselling (78.9% vs 45.2%, P<0.001) were more likely to make changes in smoking behavior at home or around their children. Conclusion: It was feasible to reduce children’s SHS exposure through community-based programs. However, our intervention showed no positive impacts on smokers’ quitting and thus more studies were expected to explore effective methods for smoking cessation intervention. To have health workers from primary health centers engaged in future projects, researchers should consider the workload and improve their job satisfaction.