Abstract
BackgroundThe CEASE (Clinical Effort Against Secondhand Smoke Exposure) intervention was developed to help pediatricians routinely and effectively address the harms of family smoking behaviors. Based on paper versions of CEASE, we partnered with the American Academy of Pediatrics’ online education department and developed a completely distance-based training, including an online CME training, handouts and education materials for families, and phone and email support.MethodsThe pediatric offices of two low income health clinics with primarily Medicaid populations were selected for the study. Pre and post intervention data by survey of the parents was collected in both practices (Practice 1 n = 470; Practice 2 n = 177). The primary outcome for this study was a comparison of rates of clinician’s asking and advising parents about smoking and smoke-free home and cars.ResultsExit surveys of parents revealed statistically significant increases in rates of clinicians asking about parental smoking (22% vs. 41%), smoke-free rules (25% vs. 44%), and asking about other smoking household members (26% vs. 48%).ConclusionsThrough a completely distance based intervention, we were able to train pediatricians who see low income children to ask parents about smoking, smoke-free home and car rules, and whether other household members smoke. Implementing a system to routinely ask about family tobacco use and smoke-free home and car rules is a first step to effectively addressing tobacco in a pediatric office setting. By knowing which family members use tobacco, pediatricians can take the next steps to help families become completely tobacco-free.Trial registrationClinical trials number: NCT01087177
Highlights
The CEASE (Clinical Effort Against Secondhand Smoke Exposure) intervention was developed to help pediatricians routinely and effectively address the harms of family smoking behaviors
To train pediatric health care providers to address tobacco use and the tobacco smoke exposure of children, we have developed a comprehensive training, support, and dissemination system, CEASE (Clinical Effort Against Secondhand Smoke Exposure)
As expected for such health clinics, the majority of families were insured through Medicaid (80% in control, 70% in intervention)
Summary
The CEASE (Clinical Effort Against Secondhand Smoke Exposure) intervention was developed to help pediatricians routinely and effectively address the harms of family smoking behaviors. Exposure to tobacco smoke is harmful to children, resulting in higher rates of pneumonia, ear infections, sudden infant death syndrome (SIDS), asthma, and numerous other negative health effects [1]. The tobacco smoke exposure (TSE) of children due to parental tobacco use is a serious and prevalent health issue; research conducted over the course of the past decade shows that over 25. Low rates of tobacco control services may be due to a lack of knowledge of how to address tobacco use and exposure and office systems that do not support routine screening and assistance for parents who smoke. Many pediatricians reported lacking tools for the pediatric setting to address tobacco use and the tobacco smoke exposure of children [11]. In the 2006 Ambulatory Pediatric Association Policy on Tobacco, clinician training programs are urged to increase delivery of services in tobacco prevention, cessation, and the reduction of secondhand smoke exposure [12]
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