Intervening With Smoking Parents of Inpatients to Reduce Exposure: The INSPIRE Randomized Controlled Trial.


Journal

Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145

Informations de publication

Date de publication:
08 2022
Historique:
received: 29 04 2021
revised: 08 11 2021
accepted: 13 11 2021
pubmed: 25 11 2021
medline: 10 8 2022
entrez: 24 11 2021
Statut: ppublish

Résumé

Hospitalized children have high rates of tobacco smoke exposure; parents who smoke may be receptive to interventions during their child's hospitalization. We tested the efficacy of a smoking cessation intervention for parents of hospitalized children. We conducted a randomized, single-blind clinical trial from 12/14-5/18 at the Children's Hospital Colorado. Hospitalized children who had a parent who smoked tobacco were eligible. Intervention participants received motivational interviewing sessions, 2 weeks of nicotine replacement therapy; both groups received referral to the Quitline Consenting parents completed a questionnaire; urine was collected from the child for measurement of cotinine. Our primary outcome was: 1) increase in reporting "no one is allowed to smoke anywhere" in the home (smoke-free home rule). Additional outcomes included: 2) change in child's cotinine from baseline to 1 year, and 3) parental quitting at 1 year. Data were analyzed using Chi-square and t tests for bivariable data, and multivariable logistic and linear regression. Of 1641 eligible families approached, 252 were randomized (15%); 149 families had follow-up data at 12 months (59%). In the adjusted analysis, there was no difference between the groups in smoke free home rules, or child cotinine level; in an intention-to-treat analysis, 15% in the intervention group versus 8% of controls reported quit (p=0.07). A smoking cessation intervention can be delivered to parents of hospitalized children. While hospitalization provides an opportunity to help parents quit smoking, more efficient and effective engagement strategies are needed to optimize tobacco control success.

Sections du résumé

BACKGROUND
Hospitalized children have high rates of tobacco smoke exposure; parents who smoke may be receptive to interventions during their child's hospitalization.
OBJECTIVE
We tested the efficacy of a smoking cessation intervention for parents of hospitalized children.
METHODS
We conducted a randomized, single-blind clinical trial from 12/14-5/18 at the Children's Hospital Colorado. Hospitalized children who had a parent who smoked tobacco were eligible.
INTERVENTION
Intervention participants received motivational interviewing sessions, 2 weeks of nicotine replacement therapy; both groups received referral to the Quitline Consenting parents completed a questionnaire; urine was collected from the child for measurement of cotinine. Our primary outcome was: 1) increase in reporting "no one is allowed to smoke anywhere" in the home (smoke-free home rule). Additional outcomes included: 2) change in child's cotinine from baseline to 1 year, and 3) parental quitting at 1 year. Data were analyzed using Chi-square and t tests for bivariable data, and multivariable logistic and linear regression.
RESULTS
Of 1641 eligible families approached, 252 were randomized (15%); 149 families had follow-up data at 12 months (59%). In the adjusted analysis, there was no difference between the groups in smoke free home rules, or child cotinine level; in an intention-to-treat analysis, 15% in the intervention group versus 8% of controls reported quit (p=0.07).
CONCLUSIONS
A smoking cessation intervention can be delivered to parents of hospitalized children. While hospitalization provides an opportunity to help parents quit smoking, more efficient and effective engagement strategies are needed to optimize tobacco control success.

Identifiants

pubmed: 34818588
pii: S1876-2859(21)00546-5
doi: 10.1016/j.acap.2021.11.010
pmc: PMC9123095
mid: NIHMS1758590
pii:
doi:

Substances chimiques

Tobacco Smoke Pollution 0
Cotinine K5161X06LL

Types de publication

Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

997-1005

Subventions

Organisme : NCI NIH HHS
ID : R01 CA181207
Pays : United States

Informations de copyright

Copyright © 2021 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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Auteurs

Karen M Wilson (KM)

University of Rochester School of Medicine, Department of Pediatrics (KM Wilson), Rochester, NY; Julius B. Richmond Center of Excellence, American Academy of Pediatrics (KM Wilson, JD Klein, and JP Winickoff), Itasca, Ill; Department of Pediatrics, University of Colorado Anschutz Medical Campus (KM Wilson, A Moss, and GS Kerby), Aurora, Colo; Children's Hospital Colorado (KM Wilson, A Moss, M Lowary, J Holstein, J Gambino, and GS Kerby), Aurora, Colo. Electronic address: Karen_Wilson@urmc.rochester.edu.

Angela Moss (A)

Department of Pediatrics, University of Colorado Anschutz Medical Campus (KM Wilson, A Moss, and GS Kerby), Aurora, Colo; Children's Hospital Colorado (KM Wilson, A Moss, M Lowary, J Holstein, J Gambino, and GS Kerby), Aurora, Colo.

Michelle Lowary (M)

Children's Hospital Colorado (KM Wilson, A Moss, M Lowary, J Holstein, J Gambino, and GS Kerby), Aurora, Colo.

Jacqueline Holstein (J)

Children's Hospital Colorado (KM Wilson, A Moss, M Lowary, J Holstein, J Gambino, and GS Kerby), Aurora, Colo.

Jessica Gambino (J)

Children's Hospital Colorado (KM Wilson, A Moss, M Lowary, J Holstein, J Gambino, and GS Kerby), Aurora, Colo.

Elizabeth Juarez-Colunga (E)

Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus (E Juarez-Colunga), Aurora, Colo.

Gwendolyn S Kerby (GS)

Department of Pediatrics, University of Colorado Anschutz Medical Campus (KM Wilson, A Moss, and GS Kerby), Aurora, Colo; Children's Hospital Colorado (KM Wilson, A Moss, M Lowary, J Holstein, J Gambino, and GS Kerby), Aurora, Colo.

Jonathan D Klein (JD)

Julius B. Richmond Center of Excellence, American Academy of Pediatrics (KM Wilson, JD Klein, and JP Winickoff), Itasca, Ill; Department of Pediatrics, University of Illinois at Chicago (JD Klein), Ill.

Melbourne Hovell (M)

Center for Behavioral Epidemiology and Community Health (C-BEACH), Graduate School of Public Health, San Diego State University (M Hovell), San Diego, Calif.

Jonathan P Winickoff (JP)

Julius B. Richmond Center of Excellence, American Academy of Pediatrics (KM Wilson, JD Klein, and JP Winickoff), Itasca, Ill; Department of Pediatrics, Mass General Hospital for Children, Harvard Medical School (JP Winickoff), Boston, Mass.

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Classifications MeSH