Parents' smoking habits can be curbed at child patient visits

When pediatricians gave them motivational talks, referrals to quitlines and avenues to replacement therapies

Pediatricians and family physicians can help their smallest patients' health in an unconventional way: turning their attention to the parents' health for part of the visit.

In a recent study, pediatricians incorporated a system called Clinical Effort Against Secondhand Smoke Exposure, or CEASE, to ask a child' s parents if they smoke. If the answer was yes, the doctor encouraged smoking cessation in a way that addressed the parents' concern for their health and their children' s health.

The pediatricians then asked the parents what might help them quit. Physicians helped start parents' quest to kick the habit by referring them to state-run quitlines or recommending, and possibly supplying them with, nicotine replacement gum or patches.

Practices that used CEASE had a 12-fold higher rate of delivering tobacco control assistance to parents compared with practices that had not adopted the program. The findings were published online June 24 in Pediatrics.

" Traditionally, pediatricians would ask a parent ' Do you smoke in the home?' And if they said no, that would be the end of the conversation. The study shows we can do more now and help parents quit smoking," said pediatrician Jonathan P. Winickoff, MD, MPH, the study' s lead author and a member of the Center for Child & Adolescent Health Research and Policy at Massachusetts General Hospital for Children.

For the study, 20 pediatric practices in 16 states received CEASE intervention or usual care. The 10 intervention practices received CEASE training and materials so they could provide evidence-based assistance to parents who smoke.

The intervention approach was used for 999 parents, and 981 parents were enrolled in control practices.

Practices that used CEASE had a 42.5% mean rate of delivering " meaningful assistance for parental cigarette smoking." The rate was 3.5% in practices that did not use CEASE.

Rates of enrollment in the quitline were 10% in CEASE practices versus 0% for practices that didn' t use the program. Provision of smoking cessation medication was 12% in CEASE practices and 0% in the other practices. Similarly, counseling for smoking cessation was 24% in the CEASE practice versus 2% in the control group.

Source: American Medical Association