Children learning about second-hand smoke (CLASS II): A pilot cluster randomised controlled trial

The pilot trial will be conducted in Dhaka Division, Bangladesh. We will recruit a total of 12 primary schools and 360, Year 5 (10-12 year old) children. The information obtained from the pilot study will help us to carefully plan for the large study and help us to test our assumptions. These include the number of schools and children to be recruited, feasibility and acceptability of the specified measurements and resource requirement for scaling up the intervention.

For the last three years, we have been working with teachers, children and their parents in primary schools in Dhaka, Bangladesh, to develop and test an intervention called, 'Smoke Free Homes'. It consists of six teaching lessons delivered by school teachers, four fun activities and one educational take-home resource. Teaching lessons help to increase pupils' knowledge about the harms caused by breathing in other people's smoke. Fun activities include storytelling, role-playing, quizzes and games. These activities help to motivate children to act and feel confident in talking to adults to persuade them not to smoke inside homes. The take-home resource helps children to show what they have learned in school and to negotiate with their families to "sign-up" to a voluntary contract to make their homes smoke-free. The results of this work show that it is possible to encourage children to discuss with their families ways of restricting smoking inside their homes.

The current trial is a pilot for a definitive trial to examine how effective 'Smoke Free Homes' is in reducing children's exposure to SHS. We will also examine if the intervention improves their lung health, general quality of life, school attendance and school performance. We would also like to examine if it helps in changing their attitude towards smoking and makes it less likely for them to take up smoking in future. Objective methods of measurements including testing children's saliva for cotinine - a chemical derivative of nicotine found in those who are exposed to SHS will be used. Other measures will include breathing tests to assess children's lung capacities and volumes, questionnaires and diaries to be kept by children to record their symptoms such as cough, wheeze and scales to measure school performance and attitudes to smoking. Findings will help us to plan for the large study.


Funder:  Medical Research Council
Start Date: April 2015
End Date: April 2017

Public Health and Society Research in the Department of Health Sciences