PONE-D-21-24273A Harm Reduction Model for Environmental Tobacco Smoke Exposure among Bangladeshi Rural Household Children: A Modified Delphi Technique ApproachPLOS ONE

Dear Dr. Noosorn,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Md Mosharaf Hossain

Academic Editor

PLOS ONE

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PONE-D-21-24273

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

Reviewer #3: No

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: No

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: 1， In the cross-sectional study, it was indicated an overwhelming participant was male (70.7%) majority were married (85.6%) and completed from university (38.5%). Please check the data about the participant completed university education.

2, It seems that the research finding can not support the research goal.

3, The manuscript looks like a research report, rather than a academic paper.

4, The tables in the manuscript need to be format again.

5, The language need polish.

Reviewer #2: • Page 6: under Phase 3: evaluation of the model; It is suggested to mention what modification was done to the Delphi technique for better clarification of the modification in the method.

• Page 6: under Phase 3: evaluation of the model; Calculation of the consensus on Interquartile range (IQR) was not clarified enough and recommended to have a proper explanation on how IQR was calculated based on the response score and the reason for the cut point is set at less than/ equal to 1. (This point links the result table shown in Page 17).

• Page 21: “The outcomes did not validate with cotinine estimation” which needs proper explanation to mention. The reason is that the Bangladeshi people have tobacco smoking and habit of betel chewing with tobacco which can be a mixed-use of tobacco and can bias the result with cotinine estimation due to the misclassification of tobacco use (inclusive of without smoke).

• In figure 2: Just want to clarify that one item was not listed in the figure. Only 12 items out of 13 consensus criteria were reflected with one point omitting “distributing leaflets, banners and stickers about ETS”. Is that point covered under “using print materials” or missed to mention?

Reviewer #3: PONE-D-21-24273: statistical review

SUMMARY: This is a study of environmental tobacco smoke exposure among children in a district of Bangladesh. Both qualitative and quantitative research methods have been implemented, across the three phases summarized by Figure 1. My review will focus on the statistical analysis of phase 1, which essentially relies on a logistic regression analysis of a cross-sectional sample.

MAJOR ISSUES

1. The sample includes households of 6 villages in the Munshiganj district, randomly selected from 64 districts. Although I understand logistics constraints, a sample of villages drawn from different districts would have been a much more natural procedure and results could have been extended to the Bangladeshi population. Taking villages from one district leads to results that are instead much more limited. I think that the overall paper should be rephrased by assuming that the target population is the rural part of the Munshiganj district.

2. If I understood correctly (not clear from text, please clarify), the dependent variable in the logistic regressions of Table 2 is always smoke exposure, included as a self-reported binary variable. I'm quite a bit concerned about the dichotomous definition of exposure: what do 0 and 1 exactly mean here? How can we be sure that all the subjects give to 0 and 1 the same meaning? Without a clear-cut definition of the dependent variable, the results of table 2 are difficult to interpret.

3. Table 2 displays the results of a battery of logistic regressions, where some relevant covariates are included separately and then adjusted for confounders. This is not a standard approach: relevant covariates should be included simultaneously. I'd welcome a single, carefully selected (see major issue 4 below) logistic regression that includes the ORs of all the relevant covariates and the confounders.

4. Model checking is overlooked. Without asking for a full model diagnostic, the authors should at least provide some residual analysis that show the goodness of fit of the model.

SPECIFIC ISSUES

1. Although the English is generally correct, some sentences should be revised. Examples are: “The cross-sectional study observed”, “Through purposive sampling, the experts were selected”, “completed from university”, “It's not liked the town”…

2. The caption of Table 2 remarks that the ORs are adjusted for some confounders (age, gender, income, religious belief, knowledge, environmental impact, media influence, perception, attitude, intention, perceived behavior control). Only some of these variables are summarized by Table 1: what about the others? In addition, Table 1 should display the ORs associated with these confounders, too.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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PONE-D-21-24273R1A Harm Reduction Model for Environmental Tobacco Smoke Exposure among Bangladeshi Rural Household Children: A Modified Delphi Technique ApproachPLOS ONE

Dear Dr. Noosorn,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please address the remaining comments from reviewer 2.

Please submit your revised manuscript by Aug 14 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Md Mosharaf Hossain

Academic Editor

PLOS ONE

and

Jamie Royle

Staff Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments (if provided):

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #3: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

Reviewer #3: No

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: No

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The authors addressed my question points comprehensively in the manuscript. Well done and thank you.

Reviewer #3: I'm generally satisfied with most of the work made by the authors in this revision. I just have some residual requests:

1) I still think that taking villages from one district coud lead to results that are difficult to extend to the general population. Although the authors disagree on this point, I would suggest to add this issue among the possbile limitations of the study.

2) Lines 245-248: "The model predicted 91.7% of the correct estimate. The model chi-square (x2=371.792, df. = 40, p = 0.000), assessing goodness-of-fit, was significant, indicating that the independent variables are not related to the log odds of the dependent variable." The meaning of these two sentences is not clear. I suggest to remove them. The Hosmer and Lemeshow test provides enough information about the model goodness of fit.

3) Data: I was not able to retrieve the data from Dryad, using the address the authors provided, doi:10.5061/dryad.f7m0cfxz7. Please provide a link that directly points to the dataset

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Reviewer #2: Yes: Sun Tun

Reviewer #3: No

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A Harm Reduction Model for Environmental Tobacco Smoke Exposure among Bangladeshi Rural Household Children: A Modified Delphi Technique Approach

PONE-D-21-24273R2

Dear Dr. Noosorn,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Muhammad Tayyab Sohail

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #3: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

Reviewer #3: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

Reviewer #3: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: (No Response)

Reviewer #3: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Sun Tun

Reviewer #3: No

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