A Smoking Cessation Intervention for Parents of Children Who Are Hospitalized for Respiratory Illness: The Stop Tobacco Outreach Program

Winickoff, Jonathan P.; Hillis, Valerie J.; Palfrey, Judith S.; Perrin, James M.; Rigotti, Nancy A.

doi:10.1542/peds.111.1.140

Cited by 130 publications

(182 citation statements)

References 35 publications

(33 reference statements)

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“…Other studies, focusing on parents of older children admitted to the hospital with asthma, have shown that illness provides a "teachable moment." 1,3,12 However in our study, the parents of sicker infants were less likely to accept referral. Perhaps the danger of secondhand smoke to premature lungs is less apparent or compelling to parents than the danger of smoking to an asthmatic.…”

Section: Discussioncontrasting

confidence: 65%

“…[1][2][3] Although several studies have evaluated smoking cessation in parents of newborns, fewer have evaluated smoking cessation efforts targeting parents of newborns specifically in the postpartum hospital stay. In the Newborns Excel Without Secondhand Smoke (NEWS) study, Winickoff et al found that parents in the postpartum period were receptive to enrolling in tobacco cessation services and may be more motivated to quit at that time.…”

mentioning

confidence: 99%

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A Comparison of Parents of Healthy Versus Sick Neonates: Is There a Difference in Readiness and/or Success in Quitting Smoking?

Boykan¹,

Messina

2015

Hospital Pediatrics

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A B S T R A C TOBJECTIVES: Study objectives were to compare smoking cessation rates between parents in the newborn nursery (NBN) versus the NICU and compare acceptance of referral to the New York State Smoker's Quitline (NYSSQL) between the 2 units. Secondary aims were to identify opportunities for improved smoking cessation interventions with parents of newborns. METHODS:From January through December 2013, smoking parents/caregivers of infants in the NBN and NICU (n 5 226) completed a 34-item questionnaire. For those who accepted electronic referral to the NYSSQL, participation/outcome data and questionnaire data were matched. Relationships were examined using the x 2 test of independence. RESULTS:The majority of respondents had cut back (56%) or quit (36%) prenatally. Seventy-nine percent of NBN parents accepted referred to the NYSSQL versus 53% of NICU parents; odds ratio 5 3.31 (1.48-7.40; P , .01). At 7-to 8-month follow-up (n 5 35): 11 of 28 (NBN) versus 0 of 7 (NICU) quit, 11 of 28 (NBN) versus 5 of 7 (NICU) cut back, 6 of 28 (NBN) versus 2 of 7 (NICU) did not quit/cut back (P 5 .13). Significantly more mothers (80%; 16/20) compared with fathers (46%; 6/13) quit/cut back, 20% (4/20) of mothers versus 54% (7/13) of fathers did not quit/cut back (P 5 .04). Exclusive formula-feeding rates were higher in this cohort of smokers surveyed than in all parents of infants admitted to the NBN/NICU for the same year (45% vs 13%). CONCLUSIONS:In this study population, parents of healthy newborns were more receptive to quitline referrals than parents of infants admitted to the NICU.

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Section: Discussioncontrasting

confidence: 65%

mentioning

confidence: 99%

A Comparison of Parents of Healthy Versus Sick Neonates: Is There a Difference in Readiness and/or Success in Quitting Smoking?

Boykan¹,

Messina

2015

Hospital Pediatrics

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“…Questions used in this study to assess tobacco control service delivery were used previously in our other inpatient or outpatient studies. 16,22 Covariates collected included gender, age, race, education, smoking history, smoking behavior inside the home and car, and attitudes about the dangers of child' s TSE.…”

Section: Methodsmentioning

confidence: 99%

“…11,16,21,22,[29][30][31][32] The intervention includes (1) routine screening for parental tobacco use using a CEASE Action Sheet, which helped the office staff identify each smoking family member and document smoking status in the child' s medical record; (2) motivational messaging that is based on the parents' own concerns as well as potential teachable moments that may be cued by the child' s illness; and (3) recommendation and possible provision of nicotine patch and gum by the clinician, and enrollment in the free state quitline. The intervention is designed to function within existing systems of care; research staff deliver none of the clinical tobacco dependence treatment.…”

Section: Interventionmentioning

confidence: 99%

“…20 Effective strategies to help parents quit smoking are currently not implemented in the pediatric outpatient setting, despite this strong evidence that a child' s visit to the doctor provides a teachable moment for parental smoking cessation. [21][22][23] Our team has shown that parents accept smoking cessation medications and quitline enrollment in this clinical context. 24,25 The extent to which these evidence-based tobacco control strategies could be routinely implemented in the pediatric outpatient setting is not known.…”

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confidence: 99%

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Implementation of a Parental Tobacco Control Intervention in Pediatric Practice

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Young adult smokers frequently encounter the health care system as parents coming in for their child' s medical visit. Child health care clinicians, however, do not typically provide smoking cessation assistance to parents. WHAT THIS STUDY ADDS:This national cluster-randomized trial demonstrates that a tobacco dependence intervention for parents can be effectively implemented in routine pediatric outpatient practice.abstract OBJECTIVE: To test whether routine pediatric outpatient practice can be transformed to assist parents in quitting smoking. METHODS:Cluster RCT of 20 pediatric practices in 16 states that received either CEASE intervention or usual care. The intervention gave practices training and materials to change their care delivery systems to provide evidence-based assistance to parents who smoke. This assistance included motivational messaging; proactive referral to quitlines; and pharmacologic treatment of tobacco dependence. The primary outcome, assessed at an exit interview after an office visit, was provision of meaningful tobacco control assistance, defined as counseling beyond simple advice (discussing various strategies to quit smoking), prescription of medication, or referral to the state quitline, at that office visit.RESULTS: Among 18 607 parents screened after their child' s office visit between June 2009 and March 2011, 3228 were eligible smokers and 1980 enrolled (999 in 10 intervention practices and 981 in 10 control practices). Practices' mean rate of delivering meaningful assistance for parental cigarette smoking was 42.5% (range 34%-66%) in the intervention group and 3.5% (range 0%-8%) in the control group (P , .0001). Rates of enrollment in the quitline (10% vs 0%); provision of smoking cessation medication (12% vs 0%); and counseling for smoking cessation (24% vs 2%) were all higher in the intervention group compared with the control group (P , .0001 for each). CONCLUSIONS:A system-level intervention implemented in 20 outpatient pediatric practices led to 12-fold higher rates of delivering tobacco control assistance to parents in the context of the pediatric office visit.

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Brief Interventions and Motivational Interviewing With Children, Adolescents, and Their Parents in Pediatric Health Care Settings

Erickson¹,

Gerstle²,

Feldstein³

2005

Arch Pediatr Adolesc Med

242

174

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There is increasing demand for physicians in pediatric settings to address not only the physical but also the psychosocial health of their child and adolescent patients. Brief interventions (BIs), and in particular Motivational interviewing (MI), offer an efficient means of targeting behavioral, developmental, and social problems within the context of pediatric practice. This review addresses the patient-centered care foundation of and empirical support for brief pediatric interventions, including educational and media-based interventions, MI-based prevention and intervention with health risk behaviors, procedural pain control, and adherence to treatment recommendations. In addition, developmental considerations and future directions for BI research in pediatric practice are summarized.Physicians in pediatric health care settings address complex challenges in providing comprehensive care to children, adolescents, and their parents. Toward this end, BIs have been used in pediatric settings to aid in the prevention, early detection, and brief treatment of behavioral, developmental, and social problems associated with health care concerns to serve children and their families more effectively. Brief interventions encompass a diverse range of theoretically based approaches, intervention targets, and delivery methods to address such issues as educational and media-based interventions, MIbased prevention and intervention with health risk behaviors, procedural pain control, and adherence to health care recommendations. One particularly efficacious form of BI used extensively with health risk behaviors is MI.

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A Smoking Cessation Intervention for Parents of Children Who Are Hospitalized for Respiratory Illness: The Stop Tobacco Outreach Program

Cited by 130 publications

References 35 publications

A Comparison of Parents of Healthy Versus Sick Neonates: Is There a Difference in Readiness and/or Success in Quitting Smoking?

A Comparison of Parents of Healthy Versus Sick Neonates: Is There a Difference in Readiness and/or Success in Quitting Smoking?

Implementation of a Parental Tobacco Control Intervention in Pediatric Practice

Brief Interventions and Motivational Interviewing With Children, Adolescents, and Their Parents in Pediatric Health Care Settings

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