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Passive smoking in babies: The BIBE study (Brief Intervention in babies. Effectiveness)

Guadalupe Ortega1, Cristina Castellà2, Carlos Martín-Cantera3456*, Jose L Ballvé2, Estela Díaz7, Marc Saez89, Juan Lozano1, Lourdes Rofes10, Concepció Morera11, Antònia Barceló89, Carmen Cabezas12, Jose A Pascual13, Raúl Pérez-Ortuño13, Esteve Saltó12, Araceli Valverde12, Mireia Jané12 and the BIBE study group14

Author Affiliations

1 Fundació Atenció Primaria, Department of Health, Generalitat de Catalunya, Barcelona, Spain

2 ABS Florida Nord, L'Hospitalet de Llobregat, Spain

3 ABS Barcelona, Pg. St. Joan, Barcelona, Spain

4 Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

5 Grupo Cardiocat de la Red REDIAPP, Barcelona, Spain

6 USR Barcelona, IDIAP Jordi Gol, Barcelona, Spain

7 ABS Montgat, Barcelona, Spain

8 Grup de Recerca en Estadística, Economía Aplicada i Salut (GRECS), Universitat de Girona, Girona, Spain

9 CIBER de Epidemiología y Salud Pública (CIBERESP), Spain

10 Hospital Universitari de Sant Joan de Reus, Reus, Spain

11 Àrea d'Avaluació. Direcció d'Atenció Primària. ICS. Girona, Spain

12 Direcció General de Salut Pública. Department of Health, Generalitat de Catalunya, Barcelona, Spain

13 Grup de Recerca en Bioanàlisi i Serveis analítics, IMIM, Barcelona, Spain

14 BIBE study group, Barcelona, Spain

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BMC Public Health 2010, 10:772  doi:10.1186/1471-2458-10-772

Published: 20 December 2010



There is evidence that exposure to passive smoking in general, and in babies in particular, is an important cause of morbimortality. Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome, acute respiratory diseases, worsening of asthma, acute-chronic middle ear disease and slowing of lung growth.

The objective of this article is to describe the BIBE study protocol. The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care, directed to mothers and fathers that smoke, in order to reduce the exposure of babies to passive smoking (ETS).


Cluster randomized field trial (control and intervention group), multicentric and open. Subject: Fathers and/or mothers who are smokers and their babies (under 18 months) that attend pediatric services in Primary Care in Catalonia.

The measurements will be taken at three points in time, in each of the fathers and/or mothers who respond to a questionnaire regarding their baby's clinical background and characteristics of the baby's exposure, together with variables related to the parents' tobacco consumption. A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit (biological determination of nicotine). The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care.


Exposure to ETS is an avoidable factor related to infant morbimortality. Interventions to reduce exposure to ETS in babies are potentially beneficial for their health.

The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits. Interventions in the form of advice, conducted by pediatric professionals, are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS.

Trial Registration

Clinical Identifier: NCT00788996.