Factors that influence passive smoking in infancy: a study among mothers of newborn babies in The Netherlands.

BACKGROUND: The aim of this study was to assess the factors that influence smoking in the presence of the infant by mothers, partners, other family members, and friends. METHODS: An observational study using questionnaires was performed with smoking and nonsmoking parents of babies between 1 and 14 months old attending Dutch well-baby clinics between February and May 1996. The main measures were prevention of passive smoking in children by mothers and the relation with self-reported attitudes, social influence, and self-efficacy. RESULTS: A total of 1702 parents completed the questionnaire (63%). A total of 1551 questionnaires were completed by the mother. Sixty-five percent of the mothers prevented passive smoking by their child. This figure was 55% for smokers and 69% for nonsmokers. Attitude was the factor that most explained preventive behavior among both smokers and nonsmokers. Among the respondents, a lack of prevention of passive smoking was significantly related to (1) a negative attitude and 2) a negative social influence exerted by their partner, (3) lower self-efficacy in reducing passive smoking, and (4) increasing age of the child. (5) Finally, a lack of prevention is associated with the mother's self-efficacy in asking others not to smoke. This association strongly differs between smoking and nonsmoking mothers. CONCLUSION: The results suggest that health education efforts should focus on attitude and self-efficacy, assuming that these precede actual behavior, and in particular on the health consequences of the exposure of young children to tobacco smoke. The information should not be restricted to parents of newborn babies; it should also focus on parents with older children. Particular attention should be paid to smokers with a low educational level. The results also indicate that education should strengthen the ability of nonsmoking parents to deal with smokers and the ability of smoking parents to deal with their own smoking behavior.

Prevalence of passive smoking in infancy in The Netherlands.

The objective of the study was to assess the prevalence of passive smoking in infancy. This was done by self-report questionnaires completed by parents who attended the well-baby clinic in the period February-May 1996. A total of 2720 questionnaires were spread among parents with babies between 1 and 14 months: smoking and non-smoking parents. The questionnaires contained questions on smoking habits, smoking at home, smoking in presence of the baby. A total of 1702 parents filled in and returned the questionnaire (63%); 24% of the mothers and 33% of their partners smoked. In 44% of the families, one or more persons smoked; 22% of the mothers and 26% of the partners smoked at home. In 39% of the families, one or both parents smoked at home; 42% of the babies were exposed to tobacco smoke in the living-room, 8% were exposed in the car, and 4% during feeding. In cases where only the mother smoked, 13% of the infants were exposed to tobacco smoke during feeding. In the families where only the partner smoked, the babies were predominantly exposed to smoke in the car (18%). If both parents smoked, the child was most frequently exposed to tobacco smoke in the living-room (73%). It can be concluded that health workers, nurses, pediatricians and family physicians should be advised to inform parents systematically of the harmful effects of passive smoking in infancy. If parents are unable or unwilling to stop smoking, it is important to advise them to refrain from smoking in the presence of the baby.

[Consensus prevention of crib death. CBO (Central Guidance Organization for Peer Review)]. / Consensus preventie van wiegendood. Centraal Begeleidingsorgaan voor de Intercollegiale Toetsing.

The sudden and unforeseen death of a child in the first two years, usually happening during a sleeping period, is known as cot death. As cot death is a very tragic and dramatic experience for the family, it is important to reduce its incidence. In the period between 1972 and 1987, the number of cot deaths initially increased, but during the last decade a substantial reduction could be observed. This fluctuation can be connected with the position in which the baby is put to sleep. From 1970 the prone sleeping position was strongly recommended. Since then, the number of cot death cases increased. From 1987, a causal relationship between the prone sleeping position and cot death was suspected. As a result the prone sleeping position was strongly advised against. A reduction of cot death cases was then observed. By now, the role of many other factors in cot death has been perceived. The risk of cot death is increased if these factors act at the same time. Some of these factors that promote cot death come from the child's environment and can be influenced when kept in mind. Apart from the prone or side sleeping position, heat congestion, unsafe bed material and smoking in the presence of the child substantially increase the risk of cot death. The main recommendations of the committee which drew up the Dutch consensus report on prevention of cot death are therefore aimed at avoiding the above mentioned risk factors. Continuation of research is necessary to further reduce the current number of some 50 cases of cot death which happen yearly in the Netherlands.