Hard to Reach or Just Not Enough? A Narrative Review of Inpatient Tobacco Cessation Programs in Pediatrics

Abstract

Caregiver smoking is a significant risk factor for children with acute and chronic diseases. Hospitalization presents an opportunity to explore caregiver smoking as a modifiable risk factor during a time of crisis when the motivation to change could be heightened. To date, there has not been a published review on inpatient smoking cessation interventions in pediatrics that focus on supporting caregivers of hospitalized children. The goals of this review were to identify and assess the reach and efficacy of tobacco cessation strategies implemented across inpatient units in pediatrics and mother-baby units. This review also proposes clinical and research implications along with program-building recommendations that can help inform future practice in tobacco cessation. A narrative review of the literature identified 14 peer-reviewed studies that described smoking cessation interventions between 2002 and 2021. There were five randomized controlled trials, seven prospective studies, and one retrospective study. The primary kinds of interventions were counseling to heighten caregiver contemplation to quit (n = 12), provision of Nicotine Replacement Therapy (NRT) medications (n = 7), and follow-up with the local Quitline (n = 12). A diverse range of deliverers implemented interventions across studies. Variation in defining quit attempts along with tobacco reduction and cessation outcomes contributed to mixed findings across studies.

Trends and factors associated with secondhand smoke exposure among US cancer survivors, 2013–2020

“…39 For example, future research may focus on identifying the barriers and difficulties faced by caregivers and family members when quitting smoking. Studies have documented that these challenges include heightened stress or a lack of knowledge regarding the impact of SHS 44 ; therefore, interventional approaches need to be tailored for caregivers that incorporate emotional support, cultural competence, and practical assistance. 45 Additionally, cost-effectiveness analyses could help to determine the economic impact of integrating smoking cessation interventions for caregivers into cancer care settings.…”

When there is no air, the cradle will fall: A narrative review of tobacco-related content across infant safe sleep interventions

“…In addition, part of the complexities surrounding this issue center on variations in tobacco control policies (e.g., smokefree legislation, tobacco cessation) around tobacco exposure among the pediatric population ( 12 ). Of note, tobacco cessation efforts have demonstrated success among caregivers of infants and children in several prior studies ( 13 ) which further yields promise in integrating relevant content into infant sleep safety interventions. However, it has been integrated in parts of some safe sleep interventions as the basis to account for more SIDS-related risk factors.…”

“…In addition, part of the complexities surrounding this issue center on variations in tobacco control policies (e.g., smokefree legislation, tobacco cessation) around tobacco exposure among the pediatric population (12). Of note, tobacco cessation efforts have demonstrated success among caregivers of infants and children in several prior studies (13) which further yields In fact, multiple risk factors for SIDS are cumulative in effect. For example, infants sleeping in prone positions amidst shared bed spaces are more likely to be at a higher risk for SIDS with increased tobacco exposure (8).…”