FRESH: Long-term outcomes of a randomized trial to reduce radon and tobacco smoke in the home

Ellen J. Hahn, Amanda T. Wiggins, Kathy Rademacher, Karen M. Butler, Luz Huntington-Moskos, Mary Kay Rayens

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Introduction Tobacco smoke and radon are the leading causes of lung cancer. The FRESH intervention was a randomized controlled trial of 515 homeowners to promote stage of action to reduce radon and air nicotine levels. Methods We studied 515 participants, 257 in a treatment group and 258 in a control group. Treatment participants received free radon and air nicotine test kits, report back, and telephone support, and those participants whose homes had high radon levels received a voucher for $600 toward mitigation. Both groups were asked to retest 15 months post intervention. We examined differences in stage of action to test for and mitigate radon and adopt a smoke-free-home policy and in observed radon and air nicotine values by study group over time. Results Homeowners in the treatment group scored higher on stage of action to test for radon and air nicotine and to mitigate for radon during follow-up than those in the control group at 3 months and 9 months, but the effect of the intervention diminished after 9 months. We saw no difference between groups or over time in observed radon or air nicotine values. Of homeowners in the treatment group with high radon levels at baseline, 17% mitigated, and 80% of them used the voucher we provided. Conclusion The null finding of no significant change in observed radon or air nicotine values from baseline to 15 months may reflect the low proportion of radon mitigation systems installed and the decline in stage of action to adopt a smoke-free home policy. Including a booster session at 9 months post intervention may improve the remediation rate.

Original languageEnglish
Article number180634
JournalPreventing chronic disease
Issue number9
StatePublished - Sep 1 2019

Bibliographical note

Funding Information:
This project was funded by the National Institute of Environmental Health Sciences (NIEHS) and the National Institute of General Medical Sciences (NIGMS) (R01ES021502). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIEHS, NIGMS, or the National Institutes of Health. The authors have no competing financial interests. No copyrighted surveys, instruments, or tools were used in this article.

Publisher Copyright:
© 2019 Centers for Disease Control and Prevention (CDC).

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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