Clinical Research Directory

Educational Models for Tobacco Exposure Awareness

This is a randomized controlled trial comparing the effects of peer education and traditional education on increasing knowledge and awareness of secondhand and thirdhand tobacco smoke exposure among geriatric care program students. Tobacco use and passive smoking are serious public health problems that cause millions of deaths each year and are highly prevalent among university students. Not only smoke dispersed in the air (secondhand smoke), but also toxic residues that accumulate on surfaces and can be absorbed through the skin and ingestion (thirdhand smoke) carry carcinogenic risks. It is a professional obligation for these students, who are the health professionals of the future, to protect the vulnerable elderly population they will serve from this exposure (especially residues carried on clothing/hair). It is also aimed to protect their own health against the risk of smoking triggered by occupational stress. Traditional education that only imparts information may be insufficient in changing behavior. Peer education based on Social Learning Theory offers a sincere and effective alternative that encounters less resistance among young people. While existing experimental studies in the literature generally focus on "active smoking and motivation to quit," this study fills an important gap by focusing on passive and third-hand exposure. If successful, this peer education model could be implemented as a standardized educational module at the national level in university campuses. Research hypotheses: H1: Students who receive peer education have higher levels of knowledge about secondhand smoke than students who receive traditional education. H2: Students who receive peer education have higher levels of awareness about thirdhand smoke than students who receive traditional education. H3: There is a difference between the pre- and post-intervention and between the experimental and control groups in terms of students' average scores for their awareness level of secondhand smoke. H4: There is a difference between the pre- and post-intervention and between the experimental and control groups in terms of students' average scores for their knowledge level of thirdhand smoke.

Maternal Smoking Exposure and Newborn Outcomes: Study Using Urinary Cotinine

Prenatal exposure to tobacco smoke-whether from active maternal smoking or secondhand exposure-has been linked to adverse neonatal adaptation and metabolic stress. This single-center prospective observational cohort will quantify maternal smoking exposure using maternal urinary cotinine around delivery and examine its association with early neonatal physiologic and biochemical outcomes within the first 24 hours of life. Participants will be pregnant individuals delivering at a tertiary academic hospital and their newborns. After consent, mothers will provide a urine sample for cotinine measurement. Based on pre-specified cotinine thresholds and maternal history, dyads will be classified into three exposure groups: Active smoker, Passive exposure, or No exposure. No experimental intervention is administered; all neonatal assessments are part of routine peripartum care. Neonatal data collected (per standard practice) will include: umbilical cord blood gas parameters (pH, base excess, lactate) and fetal carboxyhemoglobin (FCOHb); birthweight; vital signs/blood pressure at \~6 hours; routine laboratory indices (e.g., hemogram, lipids such as HDL/LDL where available per unit protocol); heel-prick TSH from the standard newborn screen; and hearing screening result prior to discharge. Additional maternal and perinatal covariates (e.g., age, parity, gestational age, delivery mode, intrapartum events) will be recorded to support adjusted analyses. No extra phlebotomy beyond standard care will be performed; the study leverages existing clinical samples and measurements. Primary objective is to determine whether higher maternal cotinine-defined exposure is associated with greater metabolic stress at birth (indexed by cord lactate and related gas parameters) and higher FCOHb. Key secondary objectives include evaluating associations with birthweight, early blood pressure, TSH, hearing screen outcomes, and routine laboratory markers. Prespecified subgroup and sensitivity analyses (e.g., by gestational age strata or delivery mode) will be conducted as feasible. The planned sample includes approximately three cotinine-stratified cohorts recruited consecutively. Statistical analyses will follow a pre-registered plan using multivariable regression to adjust for confounders; ROC analyses may be used to explore cotinine thresholds predictive of adverse neonatal indices. Enrollment is anticipated to start October 13, 2025, with primary data collection completed within 2-3 months of recruitment initiation. This study will provide pragmatic, prospectively collected evidence on how biochemically verified maternal tobacco exposure relates to immediate neonatal metabolic, cardiovascular, endocrine, and auditory outcomes, using measurements obtainable in routine care.