Implementation of a Parental Tobacco Control Intervention in Pediatric Practice

Winickoff JP, Nabi-Burza E, Chang Y, Finch S, Regan S, Wasserman R, Ossip D, Woo H, Klein J, Dempsey J, Drehmer J, Hipple B, Weiley V, Murphy S, Rigotti NA. Pediatrics. 2013 Jun 24. [Epub ahead of print]

This study tested whether routine pediatric outpatient practice can be systematically changed to help parents of pediatric patients quit smoking. 20 pediatric practices in 16 states were recruited to receive either CEASE intervention or usual care. The intervention provided training and materials for practices to change care delivery systems to provide evidence-based assistance to parents who smoke including referral to quitlines, motivational messaging, and quitting medications. Outcomes were assessed by exit interview after an office visit, whether counseling was provided (discussing various strategies to quit smoking), medication was prescribed, or referral was made to a state quitline. Results showed that practices’ mean rate of delivering meaningful assistance was 42.5% in the intervention group and 3.5% in the control group (P<.0001). Rates were higher in the intervention group than the control group for enrollment in the quitline (10% vs. 0%); provision of medications (12% vs. 0%), and counseling for smoking cessation (24% vs. 2%). The authors conclude that a system-level intervention led to 12-fold higher rates of delivering tobacco control assistance to parents within the context of a pediatric office visit.