Tobacco Dependence
Conditions
Keywords
tobacco control, tobacco treatment, pediatrics, parents
Brief summary
The proposed study is a Cluster Randomized Controlled Trial designed to test the sustainability of a previously developed, tested, effectively implemented tobacco control strategy-the CEASE intervention, employing state of the art tobacco dependence treatment for parents who smoke.
Detailed description
The CEASE intervention works within existing systems of care to address parental smoking. Based on national guidelines and extensive qualitative research obtained in pilot testing, elements of CEASE can be tailored to work with particular practices' staffing, resources, and physical configuration. CEASE integrates evidence-based tobacco-use screening, cessation assistance, and referral to outside services into visits with families in pediatric clinics. Elements include (1) Identification of smokers and self-assessment of quitting preferences; (2) Counseling (brief motivational messaging elements include collaborative goal setting, set quit date, personal barriers to quitting, problem-solving strategies, implementing smoke-free homes and cars, and social support, strategies shown to increase satisfaction with the pediatric visit.(3) Medication (NRT prescription and free 1 week supply (while supplies last)-including for those cutting down to quit as recommended in latest guidelines); (4) Quitline enrollment via faxed enrollment form; and (5) Review of CEASE action sheets at each visit until the family is smoke-free. We train practices in the adoption, implementation, and maintenance of the intervention. A more detailed training manual discusses additional in-depth strategies for maximizing billing and reimbursement, materials for seasonal cessation opportunities and supporting employees' own cessation efforts.
Interventions
BEHAVIORALCEASE Intervention
The CEASE intervention works within existing systems of care to address parental smoking. Elements include (1) Identification of smokers and self-assessment of quitting preferences; (2) Counseling (brief motivational messaging elements include collaborative goal setting, set quit date, personal barriers to quitting, problem-solving strategies, implementing smoke-free homes and cars, and social support, strategies shown to increase satisfaction with the pediatric visit. (3) Medication (NRT prescription and free 1 week supply (while supplies last)-including for those cutting down to quit as recommended in latest guidelines); (4) Quitline enrollment; and (5) Review of CEASE action sheets at each visit until the family is smoke-free.
Sponsors
National Institutes of Health (NIH)
National Cancer Institute (NCI)
American Academy of Pediatrics
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Parents or guardians who smoke or who are former smokers (quit in the last 2 years), are present at the visit, and whose child (any age) is seen by a pediatrician in a participating practice. * Smoker will be defined as answering yes to the screening question: Have you smoked a single cigarette, even a puff, in the past 7 days? * Former smoker will be defined as answering no to the screening question: Have you smoked a single cigarette, even a puff, in the past 7 days? and yes to the screening question: Have you quit smoking in the last 2 years?
Exclusion criteria
* Parents under age 18 * Parents who have a child with a medical emergency (any condition requiring transfer for immediate medical intervention) * Non-consenting individuals * Non-English speakers * Prior enrollment in the study during a previous healthcare visit.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Delivery of Assistance | over 2 years | • Delivery of cessation assistance, defined as prescribing medication, or enrolling in the quitline or other program |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in practice prevalence of parents who smoke | over 2 years | Change in practice prevalence of parents who smoke assessed at baseline and at 2 years |
| Parental quit rate | over 2 years | Change in parental quit rate at the practice: quit in the last 2 years, cotinine-confirmed at baseline and at 2 years |
| Smokefree homes and cars | over 2 years | • Reduced parental smoking inside homes and cars assessed by previously validated, self-reported strictly enforced rules prohibiting smoking in the home and car |
| Parental use of pharmacotherapy or services | over 2 years | Use of services from any smoking cessation program and/or pharmacotherapy to help quit smoking |
Countries
United States
Outcome results
None listed