Systematic review of behaviour change techniques within interventions to reduce environmental tobacco smoke exposure for children

Tracey J. Brown*, Sarah Gentry, Linda Bauld, Elaine M. Boyle, Paul Clarke, Wendy Hardeman, Richard Holland, Felix Naughton, Sophie Orton, Michael Ussher, Caitlin Notley

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)


Children are particularly vulnerable to environmental tobacco smoke (ETS). There is no routine support to reduce ETS in the home. We systematically reviewed trials to reduce ETS in children in order to identify intervention characteristics and behaviour change techniques (BCTs) to inform future interventions. We searched Medline, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Central Register of Controlled Trials, and Cochrane Tobacco Addiction Group Specialised Register from January 2017 to June 2020 to update an existing systematic review. We included controlled trials to reduce parent/caregiver smoking or ETS in children <12 years that demonstrated a statistically significant benefit, in comparison to less intensive interventions or usual care. We extracted trial characteristics; and BCTs using Behaviour Change Technique Taxonomy v1. We defined “promising” BCTs as those present in at least 25% of effective interventions. Data synthesis was narrative. We included 16 trials, of which eight were at low risk of bias. All trials used counselling in combination with self-help or other supporting materials. We identified 13 “promising” BCTs centred on education, setting goals and planning, or support to reach goals. Interventions to reduce ETS in children should incorporate effective BCTs and consider counselling and self-help as mechanisms of delivery.

Original languageEnglish
Article number7731
Pages (from-to)1-14
Number of pages14
JournalInternational Journal of Environmental Research and Public Health
Issue number21
Publication statusPublished - 1 Nov 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.


  • Behaviour change techniques
  • Children
  • Harm reduction
  • Postnatal
  • Secondhand smoke
  • Smoking
  • Systematic review
  • Tobacco smoke pollution


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