Proactive delivery of nicotine replacement therapy to families of hospitalized infants in a NICU: A randomized controlled pilot trial

Northrup, Thomas F.; Suchting, Robert; Klawans, Michelle R.; Khan, Amir; Villarreal, Yolanda R.; Green, Charles; Stotts, Angela L.

doi:10.1016/j.jnn.2020.01.002

Cited by 4 publications

(24 citation statements)

References 20 publications

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“…(3) there was no intervention implemented in the study; (4) the target population comprised a combination of both inpatients and outpatients; and (5) study locations included both inpatient and outpatient settings. Fourteen articles ultimately met the criteria for an inpatient tobacco cessation program for caregivers of pediatric patients as elucidated in Figure 1 [7,[14][15][16][17][18][19][20][21][22][23][24][25][26]. IRB approval or an equivalent based on the country was obtained across eleven studies that involved both quality improvement and research [14][15][16][17][19][20][21][23][24][25][26].…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen articles ultimately met the criteria for an inpatient tobacco cessation program for caregivers of pediatric patients as elucidated in Figure 1 [7,[14][15][16][17][18][19][20][21][22][23][24][25][26]. IRB approval or an equivalent based on the country was obtained across eleven studies that involved both quality improvement and research [14][15][16][17][19][20][21][23][24][25][26]. A comprehensive breakdown of each study's participant characteristics, intervention components, and tobacco reduction and cessation outcomes can be found in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Sociodemographic and illness characteristics assessed at baseline for pediatric patients across most of the studies included race/ethnicity, gender, age, and presenting diagnosis. Sociodemographics obtained for caregivers among nine of the studies included race/ethnicity, gender, age, highest level of education, and health insurance status [7,15,16,[19][20][21][22][23][24]. Five studies did not report any information on race/ethnicity of either child or caregiver [17,18,20,21,26].…”

Section: Sociodemographic Characteristics Of Participantsmentioning

confidence: 99%

“…Smoking history was obtained in nine studies and specifically explored caregiver's frequency of tobacco use, prior quit attempts, number of years smoked, prior use of Nicotine Replacement Therapy (NRT), baseline smoking status, and age when the caregiver began smoking [14][15][16][18][19][20][21]23,24]. Baseline smoking status was mainly determined with the administration of the Fagerstrom Test for Nicotine Dependence in four studies [7,15,20,21].…”

Section: Sociodemographic Characteristics Of Participantsmentioning

confidence: 99%

“…Three studies involved a combination of research assistants to obtain sociodemographic information and pediatricians to deliver the cessation intervention [14,16,26]. In one study, research associates conducted every phase of the program implementation [19].…”

Section: Research Teamsmentioning

confidence: 99%

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

Jawed

Jassal

2021

IJERPH

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Sociodemographic Characteristics Of Participantsmentioning

confidence: 99%

Section: Sociodemographic Characteristics Of Participantsmentioning

confidence: 99%

Section: Research Teamsmentioning

confidence: 99%

See 3 more Smart Citations

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

Jawed

Jassal

2021

IJERPH

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Thirdhand smoke associations with the gut microbiomes of infants admitted to a neonatal intensive care unit: An observational study

Northrup

Stotts

Suchting

et al. 2021

Environmental Research

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Thirdhand Smoke Contamination and Infant Nicotine Exposure in a Neonatal Intensive Care Unit: An Observational Study

Northrup

Stotts

Suchting

et al. 2020

Nicotine &Amp; Tobacco Research

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Introduction Thirdhand smoke (THS) is ultrafine particulate matter and residue resulting from tobacco combustion, with implications for health-related harm (e.g., impaired wound healing), particularly among hospitalized infants. Project aims were to characterize nicotine (THS proxy) transported on neonatal ICU (NICU) visitors and deposited on bedside furniture, as well as infant exposure. Methods Cross-sectional data were collected from participants in a metropolitan NICU. Participants completed a survey and CO-breath sample; and, 41.9% (n=88) of participants (N=210) were randomly selected for finger-nicotine wipes during a study phase when all bedside visitors were screened for nicotine use and finger-nicotine levels. During an overlapping study phase, 80 mother-infant dyads consented to bedside furniture-nicotine wipes and an infant-urine sample (for cotinine analyses). Results Most non-staff visitors’ fingers had nicotine above the limit-of-quantification (>LOQ; 61.9%). Almost all bedside furniture surfaces (93.8%) and infant cotinine measures (93.6%) had values >LOQ, regardless of household nicotine use. Participants who reported using (or lived with others who used) nicotine had greater furniture-nicotine contamination (Mdn=0.6 [IQR=0.2-1.6] µg/m 2) and higher infant cotinine (Mdn=0.09 [IQR=0.04-0.25] ng/ml), compared to participants who reported no household-member nicotine use (Mdn=0.5 [IQR=0.2-0.7] µg/m 2; Mdn=0.04 [IQR=0.03-0.07] ng/ml, respectively). Bayesian-univariate regressions supported hypotheses that increased nicotine use/exposure correlated with greater nicotine contamination (on fingers/furniture) and infant THS exposure. Conclusions Potential furniture-contamination pathways and infant-exposure routes (e.g., dermal) during NICU hospitalization were identified, despite hospital prohibitions on tobacco/nicotine use. This work highlights the surreptitious spread of nicotine and potential THS-related health risks to vulnerable infants during critical stages of development. Implications Thirdhand smoke (THS) contamination is underexplored in medical settings. Infants cared for in the neonatal intensive care unit (NICU) are vulnerable to health risks from THS exposure. This study demonstrated that 62% of non-staff NICU visitors transport nicotine on their fingers to the NICU. Over 90% of NICU (bedside) furniture was contaminated with nicotine, regardless of visitors’ reported household-member nicotine use or non-use. Over 90% of infants had detectable levels of urinary cotinine during NICU hospitalizations. Results justify further research to better protect infants from unintended THS exposure while hospitalized.

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Proactive delivery of nicotine replacement therapy to families of hospitalized infants in a NICU: A randomized controlled pilot trial

Cited by 4 publications

References 20 publications

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

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

Thirdhand smoke associations with the gut microbiomes of infants admitted to a neonatal intensive care unit: An observational study

Thirdhand Smoke Contamination and Infant Nicotine Exposure in a Neonatal Intensive Care Unit: An Observational Study

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