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: A Study Using Cord Blood Cotinine

Prenatal exposure to tobacco smoke, whether from active maternal smoking or secondhand exposure, has been associated with adverse neonatal adaptation, metabolic stress, and impaired fetal oxygenation. This single-center prospective observational cohort study will quantify prenatal tobacco exposure using cord blood cotinine measured at delivery and examine its association with early neonatal biochemical, metabolic, and physiologic outcomes. Participants will consist of mother-newborn dyads recruited consecutively at a tertiary academic hospital. After informed consent, cord blood obtained at delivery will be used for cotinine measurement. Based on pre-specified cotinine thresholds and maternal smoking history, newborns will be classified into three exposure groups: active exposure, passive exposure, or no exposure. No experimental intervention will be administered, and neonatal assessments will be based on routine perinatal and postnatal care. Neonatal data collected will include umbilical cord blood gas parameters (pH, pCO2, pO2, base excess, bicarbonate, and lactate), fetal carboxyhemoglobin (FCOHb), birthweight and anthropometric measurements, Apgar scores, oxygen saturation, heart rate, blood pressure, and routine laboratory indices obtained during the first postnatal day. These laboratory measures may include complete blood count parameters, inflammatory and hematologic ratios such as NLR and PLR, metabolic markers including albumin and lactate-to-albumin ratio, lipid parameters such as HDL and LDL, thyroid-stimulating hormone from the standard newborn screening program, and hearing screening results. Early follow-up data, including postnatal weight loss and bilirubin measurements at routine visits, will also be recorded where available. Maternal and perinatal covariates, including maternal age, parity, gestational age, delivery mode, intrapartum factors, smoking history, and relevant maternal comorbidities, will be collected to support adjusted analyses. The primary objective is to determine whether higher cord blood cotinine-defined exposure is associated with greater metabolic stress and impaired fetal oxygenation at birth, particularly as reflected by cord lactate, related blood gas parameters, and FCOHb. Secondary objectives include evaluating associations with early neonatal hematologic, metabolic, endocrine, and clinical indices, including birthweight, blood pressure, bilirubin levels, thyroid screening results, and hearing screening outcomes. The study will recruit consecutive eligible dyads in a prospective manner. Statistical analyses will follow a pre-specified plan and will include multivariable regression models to adjust for potential confounding factors. Sensitivity and subgroup analyses, including analyses by delivery mode and other clinically relevant strata, will be performed when feasible. This study is designed to provide prospectively collected, biochemically verified evidence on how prenatal tobacco exposure, classified by cord blood cotinine, relates to immediate neonatal metabolic, hematologic, and physiologic outcomes using measurements that are feasible within routine clinical care.