595 - Treating Nicotine Addiction in Caregivers of Children on the Pediatric Ward

Publication Number: 2580.595

Casey O'Hare, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; George A. Verdelis, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Brian Williams, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States

Background: About one-third of children ages 3-11 experience tobacco smoke exposure which can lead to various adverse health outcomes. However, there is limited evidence on how to best intervene with caregivers who smoke.

Objective: Our objectives were to 1) evaluate the feasibility and acceptability of a smoking treatment intervention (nicotine replacement therapy and counseling) for caregivers of children hospitalized at a tertiary pediatric hospital and 2) examine treatment effects on the number of cigarettes smoked and changes in self-efficacy and interest in quitting.

Design/Methods: Caregivers recruited answered "yes" to "Does anyone in your household smoke?" on the nursing admission intake screener. Children determined to be unlikely to discharge that day were then approached to confirm eligibility, assess interest in participation, and obtain informed consent. Enrolled participants completed a pre-intervention survey assessing basic demographics (age, race/ethnicity, sex, relationship to child, education) and smoking habits (past quit attempts, time to first daily cigarette, cigarettes smoked per day). The study physician then provided a 15-minute counseling session and provided a 2-week supply of nicotine patches and/or mini-lozenges. Participants then completed a follow-up survey on the day of their child's discharge and two weeks following discharge to assess smoking habits, quit interest and self-efficacy, and feedback on the intervention. Basic descriptive statistics were used to assess responses and changes in smoking behavior.

Results: We enrolled a total of 23 caregivers in this pilot study (Table 1). During the study period, 257 children were documented as having smoke exposure and 165 were approached by study coordinators. Hospitalization of < 24 hours was the primary reason for not approaching (n=78). On average, caregivers smoked 11 cigarettes per day. Out of all respondents, two (8.7%) reported no cigarette use two-weeks following discharge. Nearly all participants (78.3%) reported a decrease in daily cigarette use at discharge (mean -4.82). There was little change in confidence and motivation for quitting (Table 2). The intervention was rated highly on a 7-point scale on whether they would "recommend this study to someone else trying to quit smoking" (mean 6.77) and whether they would "participate in something similar again" (mean 6.57; Table 3).

Conclusion(s): Providing caregivers of hospitalized children with a brief intervention of counseling and nicotine replacement therapy was feasible, acceptable and led to changes in smoking behavior in this pilot study.

Table 1. Participant Demographics


Table 2. Changes in Smoking Behavior and Confidence/Motivation in Quitting
a. Items scored on a scale 1-7; higher scores reflected higher confidence/motivation

Table 3. Intervention Feasibility and Acceptability
a. Item scored on a scale 1-7; higher scores reflected higher willingness