Title

Effect of a pediatric practice-based smoking prevention and cessation intervention for adolescents: a randomized, controlled trial

UMMS Affiliation

Division of Preventive and Behavioral Medicine; Department of Psychiatry; Department of Pediatrics; Department of Family Medicine and Community Health

Date

4-3-2008

Document Type

Article

Subjects

Adolescent; Adolescent Behavior; Cognitive Therapy; Counseling; Female; Follow-Up Studies; Humans; Intervention Studies; Male; Odds Ratio; Pediatrics; Practice Management, Medical; Predictive Value of Tests; Primary Prevention; Probability; Reference Values; Risk Assessment; Smoking; Smoking Cessation; Statistics, Nonparametric; Treatment Outcome

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

OBJECTIVE: The purpose of this work was to determine whether a pediatric practice-based smoking prevention and cessation intervention increases abstinence rates among adolescents.

METHODS: Eight pediatric primary care clinics were randomly assigned to either intervention or usual care control condition. The provider- and peer-delivered intervention tested was based on the 5A model recommended by the US Public Health Service clinical practice guidelines and the American Academy of Pediatrics and consisted of brief counseling by the pediatric provider followed by 1 visit and 4 telephone calls by older peer counselors aged 21 to 25 years. A consecutive sample of patients aged 13 to 17 years scheduled for an office visit was eligible regardless of smoking status. Of 2711 patients who agreed to participate, 2709 completed baseline assessments, and 2700 (99.6%) and 2690 (99.2%) completed 6- and 12-month assessments, respectively.

RESULTS: Compared with the usual care condition, nonsmokers who received the provider- and peer-delivered intervention were significantly more likely to self-report having remained abstinent at 6-month and 12-month follow-up; smokers who received the provider- and peer-delivered intervention were more likely to report having quit at the 6-month but not the 12-month follow-up. A number of adolescent characteristics (eg, age, peer smoking, tobacco dependence, and susceptibility) were found to be predictive of abstinence at follow-up.

CONCLUSIONS: A pediatric practice-based intervention delivered by pediatric providers and older peer counselors proved feasible and effective in discouraging the initiation of smoking among nonsmoking adolescents for 1 year and in increasing abstinence rates among smokers for 6 months.

Rights and Permissions

Citation: Pediatrics. 2008 Apr;121(4):e738-47. Link to article on publisher's site

Related Resources

Link to Article in PubMed

PubMed ID

18381502