Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2013 Jul;132(1):109-17.
doi: 10.1542/peds.2012-3901.

Implementation of a parental tobacco control intervention in pediatric practice

Jonathan P Winickoff  1 , Emara Nabi-Burza, Yuchiao Chang, Stacia Finch, Susan Regan, Richard Wasserman, Deborah Ossip, Heide Woo, Jonathan Klein, Janelle Dempsey, Jeremy Drehmer, Bethany Hipple, Victoria Weiley, Sybil Murphy, Nancy A Rigotti
Affiliations
Randomized Controlled Trial

Implementation of a parental tobacco control intervention in pediatric practice

Jonathan P Winickoff et al. Pediatrics. 2013 Jul.

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.

Trial registration: ClinicalTrials.gov NCT00664261.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Randomization design.
FIGURE 2
FIGURE 2
Rates of tobacco control assistance for parental smokers in 10 control vs 10 intervention practices.
FIGURE 3
FIGURE 3
Rates of assistance by physician in control versus intervention practices.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Taylor BV, Oudit GY, Kalman PG, Liu P. Clinical and pathophysiological effects of active and passive smoking on the cardiovascular system. Can J Cardiol. 1998;14(9):1129–1139 - PubMed
    1. Wilson KM, Klein JD, Blumkin AK, Gottlieb M, Winickoff JP. Tobacco-smoke exposure in children who live in multiunit housing. Pediatrics. 2011;127(1):85–92 - PubMed
    1. Johansson A, Hermansson G, Ludvigsson J. How should parents protect their children from environmental tobacco-smoke exposure in the home? Pediatrics. 2004;113(4). Available at: www.pediatrics.org/cgi/content/full/113/4/e291 - PubMed
    1. Matt GE, Quintana PJ, Hovell MF, et al. . Households contaminated by environmental tobacco smoke: sources of infant exposures. Tob Control. 2004;13(1):29–37 - PMC - PubMed
    1. Winickoff JP, Healey EA, Regan S, et al. . Using the postpartum hospital stay to address mothers’ and fathers’ smoking: the NEWS study. Pediatrics. 2010;125(3):518–525 - PubMed

Publication types

Associated data