Air quality feedback: a tool to encourage smoke-free homes

Lead Research Organisation: University of Aberdeen
Department Name: Division of Applied Health Sciences

Abstract

Exposure to second-hand tobacco smoke (SHS) is associated with a wide-range of ill-health outcomes that are entirely preventable. More than 85% of SHS is invisible and many smokers are unaware of the impact of their smoking on air-quality in their home. Inhaling SHS can lead to effects on the respiratory system, and is likely to be especially harmful during early life. Children's exposure to SHS in the UK is estimated to cause approximately 830 healthcare consultations per day, with over 20 children per day suffering illness leading to admission to hospital. Non-smokers who live with smokers can have high SHS exposures, particularly young children who spend much of their day at home with a smoker. The UK government has stated that they wish to see two-thirds of smokers' homes being smoke-free by 2020 and the Scottish government tobacco control strategy has a target of reducing the number of children exposed to SHS at home by 50% by 2020. Recent work has also shown that SHS remains in household air for many hours after a cigarette is extinguished while previous work has demonstrated that personalized measurements of household air quality can lead to changes in smokers' smoking behavior and that visual, graphical and numerical data can be effectively explained to a wide-variety of users. This study aims to provide health workers with a simple, low-cost procedure to help change smoking behavior of parents in their house and car, and create a safer and healthier environment for children. The work will seek to help parents exchange ineffective strategies to create a smoke-free environment (e.g., opening the window when smoking in the car, smoking in another room in the house) for effective strategies (e.g. smoking outside, delaying smoking, quit smoking).

Technical Summary

The health effects of exposure to second-hand smoke (SHS) are substantial. Smoke-free legislation demonstrated the significant health benefits achievable by reducing SHS exposure. While this eliminated SHS exposure in work and many social settings, for those who live with a smoker SHS exposure has remained high. Most smokers try to protect their children from SHS, but apply strategies that are insufficiently effective. The Reducing Families' Exposure to Second-hand Smoke and Health (REFRESH) study demonstrated that providing smoking parents with objective information about the effect of their behaviours on their home's air-quality changed their behaviour and reduced children's SHS exposure. Barriers to this approach were instrumentation cost and the labour-intensive method of intervention delivery, which involved home-visits to install and retrieve air quality monitoring devices. Recent work has identified an air-quality monitor that is cheap and can be self-installed at home by the user.
This study seeks to determine how best to incorporate this new device in a simple package that can be used by NHS and non-NHS smoking intervention workers to encourage parents who smoke to make their home and car smoke-free. The project will involve three work-packages: (1) development of a theoretical framework for an intervention to promote parental self-management of home air quality using the air quality monitor, and identify the optimal way of intervention delivery; (2) work with the manufacturers of the device to refine the instrument to present the data in plots that can be easily interpreted by parents; (3) a feasibility study to evaluate intervention acceptability, likely rates of recruitment and effect size to examine the potential of a future large-scale trial. Throughout the project we will expand our partnership with key stakeholders responsible for the future adoption, delivery and sustainability of the program.

Publications

10 25 50
 
Description Smokefree Homes Network 
Organisation Action on Smoking and Health (ASH)
Department Action on Smoking and Health (ASH Scotland)
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Our group has established the Smokefree Homes Network through discussions with various NHS Health Boards across Scotland and NHS Health Scotland. This has arisen from interest in the work on air quality feedback funded by both the CSO and MRC in the past 3 years. Our team have organised meetings of the SFHN and also provide regular newsletters to partners about our research activity and policy changes that may be of interest to those working towards increasing the number of smoke-free homes.
Collaborator Contribution Partners have attended the twice annual full-day research meetings of the SFHN and provided local updates about smoke-free homes activity in their local area. The University of Edinburgh have hosted these meetings and NHS Health Scotland have provided resources for lunch and refreshments at these events.
Impact The Smoke-Free Homes Network (SFHN) was launched on the 20th May 2015. The SFHN is a working arrangement of academic, Health Board and Third Sector institutions with a common interest in increasing understanding of the potential benefits of reducing exposure to second-hand tobacco smoke (SHS) within the home. The partnership aims to drive forward work under the following five areas: Developing methods to quantify SHS exposure in the home Increase our understanding of the factors which influence SHS exposure in the home Assessing population exposure to SHS within home settings Identifying the barriers to having a smoke-free home Generating and evaluating interventions to encourage the transition to having a smoke-free home Determining the health benefits of a smoke-free home The network seeks to have a wide range of expertise. Network members collectively provide multidisciplinary expertise including SHS measurement, qualitative research, clinical medicine, health behaviour change, health psychology, health economics, communication, advocacy and policy in NHS Scotland, the Scottish Government and NGOs. The SFHRN would seek to promote rapid knowledge exchange within the participating groups and to facilitate work relevant to smoke-free home research. The network will work together to identify funding opportunities to further enhance scientific and practical knowledge about SHS exposure in the home and how this may be reduced. The group will also establish mechanisms for communicating findings nationally to NHS Boards, Housing Authorities and Associations, Allied Health Professionals and Governmental Agencies, and internationally to and via other stakeholders. The group met in 2016 on the 16th May and 13th December with approximately 20-25 participants at each meeting.
Start Year 2015
 
Description Smokefree Homes Network 
Organisation NHS Fife
Country United Kingdom 
Sector Public 
PI Contribution Our group has established the Smokefree Homes Network through discussions with various NHS Health Boards across Scotland and NHS Health Scotland. This has arisen from interest in the work on air quality feedback funded by both the CSO and MRC in the past 3 years. Our team have organised meetings of the SFHN and also provide regular newsletters to partners about our research activity and policy changes that may be of interest to those working towards increasing the number of smoke-free homes.
Collaborator Contribution Partners have attended the twice annual full-day research meetings of the SFHN and provided local updates about smoke-free homes activity in their local area. The University of Edinburgh have hosted these meetings and NHS Health Scotland have provided resources for lunch and refreshments at these events.
Impact The Smoke-Free Homes Network (SFHN) was launched on the 20th May 2015. The SFHN is a working arrangement of academic, Health Board and Third Sector institutions with a common interest in increasing understanding of the potential benefits of reducing exposure to second-hand tobacco smoke (SHS) within the home. The partnership aims to drive forward work under the following five areas: Developing methods to quantify SHS exposure in the home Increase our understanding of the factors which influence SHS exposure in the home Assessing population exposure to SHS within home settings Identifying the barriers to having a smoke-free home Generating and evaluating interventions to encourage the transition to having a smoke-free home Determining the health benefits of a smoke-free home The network seeks to have a wide range of expertise. Network members collectively provide multidisciplinary expertise including SHS measurement, qualitative research, clinical medicine, health behaviour change, health psychology, health economics, communication, advocacy and policy in NHS Scotland, the Scottish Government and NGOs. The SFHRN would seek to promote rapid knowledge exchange within the participating groups and to facilitate work relevant to smoke-free home research. The network will work together to identify funding opportunities to further enhance scientific and practical knowledge about SHS exposure in the home and how this may be reduced. The group will also establish mechanisms for communicating findings nationally to NHS Boards, Housing Authorities and Associations, Allied Health Professionals and Governmental Agencies, and internationally to and via other stakeholders. The group met in 2016 on the 16th May and 13th December with approximately 20-25 participants at each meeting.
Start Year 2015
 
Description Smokefree Homes Network 
Organisation NHS Greater Glasgow and Clyde (NHSGGC)
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Our group has established the Smokefree Homes Network through discussions with various NHS Health Boards across Scotland and NHS Health Scotland. This has arisen from interest in the work on air quality feedback funded by both the CSO and MRC in the past 3 years. Our team have organised meetings of the SFHN and also provide regular newsletters to partners about our research activity and policy changes that may be of interest to those working towards increasing the number of smoke-free homes.
Collaborator Contribution Partners have attended the twice annual full-day research meetings of the SFHN and provided local updates about smoke-free homes activity in their local area. The University of Edinburgh have hosted these meetings and NHS Health Scotland have provided resources for lunch and refreshments at these events.
Impact The Smoke-Free Homes Network (SFHN) was launched on the 20th May 2015. The SFHN is a working arrangement of academic, Health Board and Third Sector institutions with a common interest in increasing understanding of the potential benefits of reducing exposure to second-hand tobacco smoke (SHS) within the home. The partnership aims to drive forward work under the following five areas: Developing methods to quantify SHS exposure in the home Increase our understanding of the factors which influence SHS exposure in the home Assessing population exposure to SHS within home settings Identifying the barriers to having a smoke-free home Generating and evaluating interventions to encourage the transition to having a smoke-free home Determining the health benefits of a smoke-free home The network seeks to have a wide range of expertise. Network members collectively provide multidisciplinary expertise including SHS measurement, qualitative research, clinical medicine, health behaviour change, health psychology, health economics, communication, advocacy and policy in NHS Scotland, the Scottish Government and NGOs. The SFHRN would seek to promote rapid knowledge exchange within the participating groups and to facilitate work relevant to smoke-free home research. The network will work together to identify funding opportunities to further enhance scientific and practical knowledge about SHS exposure in the home and how this may be reduced. The group will also establish mechanisms for communicating findings nationally to NHS Boards, Housing Authorities and Associations, Allied Health Professionals and Governmental Agencies, and internationally to and via other stakeholders. The group met in 2016 on the 16th May and 13th December with approximately 20-25 participants at each meeting.
Start Year 2015
 
Description Smokefree Homes Network 
Organisation NHS Health Scotland
Country United Kingdom 
Sector Public 
PI Contribution Our group has established the Smokefree Homes Network through discussions with various NHS Health Boards across Scotland and NHS Health Scotland. This has arisen from interest in the work on air quality feedback funded by both the CSO and MRC in the past 3 years. Our team have organised meetings of the SFHN and also provide regular newsletters to partners about our research activity and policy changes that may be of interest to those working towards increasing the number of smoke-free homes.
Collaborator Contribution Partners have attended the twice annual full-day research meetings of the SFHN and provided local updates about smoke-free homes activity in their local area. The University of Edinburgh have hosted these meetings and NHS Health Scotland have provided resources for lunch and refreshments at these events.
Impact The Smoke-Free Homes Network (SFHN) was launched on the 20th May 2015. The SFHN is a working arrangement of academic, Health Board and Third Sector institutions with a common interest in increasing understanding of the potential benefits of reducing exposure to second-hand tobacco smoke (SHS) within the home. The partnership aims to drive forward work under the following five areas: Developing methods to quantify SHS exposure in the home Increase our understanding of the factors which influence SHS exposure in the home Assessing population exposure to SHS within home settings Identifying the barriers to having a smoke-free home Generating and evaluating interventions to encourage the transition to having a smoke-free home Determining the health benefits of a smoke-free home The network seeks to have a wide range of expertise. Network members collectively provide multidisciplinary expertise including SHS measurement, qualitative research, clinical medicine, health behaviour change, health psychology, health economics, communication, advocacy and policy in NHS Scotland, the Scottish Government and NGOs. The SFHRN would seek to promote rapid knowledge exchange within the participating groups and to facilitate work relevant to smoke-free home research. The network will work together to identify funding opportunities to further enhance scientific and practical knowledge about SHS exposure in the home and how this may be reduced. The group will also establish mechanisms for communicating findings nationally to NHS Boards, Housing Authorities and Associations, Allied Health Professionals and Governmental Agencies, and internationally to and via other stakeholders. The group met in 2016 on the 16th May and 13th December with approximately 20-25 participants at each meeting.
Start Year 2015
 
Description Smokefree Homes Network 
Organisation NHS Highland
Country United Kingdom 
Sector Public 
PI Contribution Our group has established the Smokefree Homes Network through discussions with various NHS Health Boards across Scotland and NHS Health Scotland. This has arisen from interest in the work on air quality feedback funded by both the CSO and MRC in the past 3 years. Our team have organised meetings of the SFHN and also provide regular newsletters to partners about our research activity and policy changes that may be of interest to those working towards increasing the number of smoke-free homes.
Collaborator Contribution Partners have attended the twice annual full-day research meetings of the SFHN and provided local updates about smoke-free homes activity in their local area. The University of Edinburgh have hosted these meetings and NHS Health Scotland have provided resources for lunch and refreshments at these events.
Impact The Smoke-Free Homes Network (SFHN) was launched on the 20th May 2015. The SFHN is a working arrangement of academic, Health Board and Third Sector institutions with a common interest in increasing understanding of the potential benefits of reducing exposure to second-hand tobacco smoke (SHS) within the home. The partnership aims to drive forward work under the following five areas: Developing methods to quantify SHS exposure in the home Increase our understanding of the factors which influence SHS exposure in the home Assessing population exposure to SHS within home settings Identifying the barriers to having a smoke-free home Generating and evaluating interventions to encourage the transition to having a smoke-free home Determining the health benefits of a smoke-free home The network seeks to have a wide range of expertise. Network members collectively provide multidisciplinary expertise including SHS measurement, qualitative research, clinical medicine, health behaviour change, health psychology, health economics, communication, advocacy and policy in NHS Scotland, the Scottish Government and NGOs. The SFHRN would seek to promote rapid knowledge exchange within the participating groups and to facilitate work relevant to smoke-free home research. The network will work together to identify funding opportunities to further enhance scientific and practical knowledge about SHS exposure in the home and how this may be reduced. The group will also establish mechanisms for communicating findings nationally to NHS Boards, Housing Authorities and Associations, Allied Health Professionals and Governmental Agencies, and internationally to and via other stakeholders. The group met in 2016 on the 16th May and 13th December with approximately 20-25 participants at each meeting.
Start Year 2015
 
Description Smokefree Homes Network 
Organisation NHS Lothian
Country United Kingdom 
Sector Public 
PI Contribution Our group has established the Smokefree Homes Network through discussions with various NHS Health Boards across Scotland and NHS Health Scotland. This has arisen from interest in the work on air quality feedback funded by both the CSO and MRC in the past 3 years. Our team have organised meetings of the SFHN and also provide regular newsletters to partners about our research activity and policy changes that may be of interest to those working towards increasing the number of smoke-free homes.
Collaborator Contribution Partners have attended the twice annual full-day research meetings of the SFHN and provided local updates about smoke-free homes activity in their local area. The University of Edinburgh have hosted these meetings and NHS Health Scotland have provided resources for lunch and refreshments at these events.
Impact The Smoke-Free Homes Network (SFHN) was launched on the 20th May 2015. The SFHN is a working arrangement of academic, Health Board and Third Sector institutions with a common interest in increasing understanding of the potential benefits of reducing exposure to second-hand tobacco smoke (SHS) within the home. The partnership aims to drive forward work under the following five areas: Developing methods to quantify SHS exposure in the home Increase our understanding of the factors which influence SHS exposure in the home Assessing population exposure to SHS within home settings Identifying the barriers to having a smoke-free home Generating and evaluating interventions to encourage the transition to having a smoke-free home Determining the health benefits of a smoke-free home The network seeks to have a wide range of expertise. Network members collectively provide multidisciplinary expertise including SHS measurement, qualitative research, clinical medicine, health behaviour change, health psychology, health economics, communication, advocacy and policy in NHS Scotland, the Scottish Government and NGOs. The SFHRN would seek to promote rapid knowledge exchange within the participating groups and to facilitate work relevant to smoke-free home research. The network will work together to identify funding opportunities to further enhance scientific and practical knowledge about SHS exposure in the home and how this may be reduced. The group will also establish mechanisms for communicating findings nationally to NHS Boards, Housing Authorities and Associations, Allied Health Professionals and Governmental Agencies, and internationally to and via other stakeholders. The group met in 2016 on the 16th May and 13th December with approximately 20-25 participants at each meeting.
Start Year 2015
 
Description Smokefree Homes Network 
Organisation University of Edinburgh
Department Centre for Population Health Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution Our group has established the Smokefree Homes Network through discussions with various NHS Health Boards across Scotland and NHS Health Scotland. This has arisen from interest in the work on air quality feedback funded by both the CSO and MRC in the past 3 years. Our team have organised meetings of the SFHN and also provide regular newsletters to partners about our research activity and policy changes that may be of interest to those working towards increasing the number of smoke-free homes.
Collaborator Contribution Partners have attended the twice annual full-day research meetings of the SFHN and provided local updates about smoke-free homes activity in their local area. The University of Edinburgh have hosted these meetings and NHS Health Scotland have provided resources for lunch and refreshments at these events.
Impact The Smoke-Free Homes Network (SFHN) was launched on the 20th May 2015. The SFHN is a working arrangement of academic, Health Board and Third Sector institutions with a common interest in increasing understanding of the potential benefits of reducing exposure to second-hand tobacco smoke (SHS) within the home. The partnership aims to drive forward work under the following five areas: Developing methods to quantify SHS exposure in the home Increase our understanding of the factors which influence SHS exposure in the home Assessing population exposure to SHS within home settings Identifying the barriers to having a smoke-free home Generating and evaluating interventions to encourage the transition to having a smoke-free home Determining the health benefits of a smoke-free home The network seeks to have a wide range of expertise. Network members collectively provide multidisciplinary expertise including SHS measurement, qualitative research, clinical medicine, health behaviour change, health psychology, health economics, communication, advocacy and policy in NHS Scotland, the Scottish Government and NGOs. The SFHRN would seek to promote rapid knowledge exchange within the participating groups and to facilitate work relevant to smoke-free home research. The network will work together to identify funding opportunities to further enhance scientific and practical knowledge about SHS exposure in the home and how this may be reduced. The group will also establish mechanisms for communicating findings nationally to NHS Boards, Housing Authorities and Associations, Allied Health Professionals and Governmental Agencies, and internationally to and via other stakeholders. The group met in 2016 on the 16th May and 13th December with approximately 20-25 participants at each meeting.
Start Year 2015
 
Title Dylos User Interface 
Description The Dylos GUI software has been developed as part of the AFRESH project. It provides a much simpler user interface to download data from Dylos air quality instruments and to present this for use in smoke-free home interventions. The software automatically produces a graph with some quantitative data about the level of second-hand smoke measured in the home. 
Type Of Technology Software 
Year Produced 2015 
Open Source License? Yes  
Impact The software is currently being further developed for use in the pilot study phase of the AFRESH project. 
URL http://www.smokefreehomes.network
 
Description Interview with Sunday Times about smoke-free homes 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Interview with journalist from the Sunday Times about measures to protect children from second-hand smoke. Resulted in front page headline in national newspaper and considerable debate in other media outlets.
Year(s) Of Engagement Activity 2017
URL https://www.thetimes.co.uk/article/ban-smoking-at-home-say-scots-campaigners
 
Description Media engagement about measuring IAQ in homes 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Press release about levels of second-hand smoke measured in homes and how this compared to outdoor air pollution. Generated a response from the Scottish Government and interest in several national newspapers. Several contacts from members of the public afterwards asking about air quality.
Year(s) Of Engagement Activity 2016
URL http://www.dailyrecord.co.uk/news/scottish-news/you-smoke-your-home-you-7398049
 
Description Presentation at Scottish Smoking Cessation Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation on how to protect children from the harms of second-hand smoke as a themed discussion session at the 2017 Scottish Smoking Cessation Conference in Glasgow. Attended by about 40 delegates.
Year(s) Of Engagement Activity 2017
URL http://www.healthscotland.scot/publications/scottish-smoking-cessation-conference-2017-themed-discus...
 
Description Presentation at Scottish Smoking Cessation Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Two linked presentation to the Scottish Smoking Cessation Conference in Edinburgh on 21st November 2016.
Using air quality feedback to facilitate smoke-free homes through the NHS Lanarkshire First Steps programme presented by Dr Sean Semple followed by
First Steps to Smoke-free Intervention: Findings from Qualitative Interviews with Mothers presented by Dr Rachel O'Donnell.

A third presentation showing the progression from FS2SF to the AFRESH project was then made by Ruaraidh Dobson
Approximately 30 attendees from NHS Health Boards, policy makers and academics attended.
Year(s) Of Engagement Activity 2016
URL http://www.healthscotland.scot/events/2016/november/scottish-smoking-cessation-conference-2016
 
Description Smoke-free homes network meeting NHS Lanarkshire 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other audiences
Results and Impact Approximately 30 people attended the Smoke-Free Homes Network workshop to learn about the outcomes of the FS2SF project. These were NHS tobacco control practitioners from across Scotland
Year(s) Of Engagement Activity 2019