Janelle Dempsey1, Susan Regan2, Jeremy E Drehmer1, Stacia Finch3, Bethany Hipple1, Jonathan D Klein4, Sybil Murphy1, Emara Nabi-Burza1, Deborah Ossip5, Heide Woo6, Jonathan P Winickoff7. 1. Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass. 2. General Medicine Division, Massachusetts General Hospital, Boston, Mass. 3. Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, Ill. 4. AAP Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Ill. 5. Department of Public Health Sciences, University of Rochester, Rochester, NY. 6. UCLA West Los Angeles Office, Los Angeles, Calif. 7. Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass; General Medicine Division, Massachusetts General Hospital, Boston, Mass; Department of Public Health Sciences, University of Rochester, Rochester, NY. Electronic address: jwinickoff@mgh.harvard.edu.
Abstract
OBJECTIVE: To examine racial differences in rates of screening parents for cigarette smoking during pediatric outpatient visits and to determine if a parental tobacco control intervention mitigates racial variation in whether cigarette smoking is addressed. METHODS: As part of the Clinical Effort Against Secondhand Smoke Exposure (CEASE) randomized controlled trial, exit interviews were conducted with parents at 10 control and 10 intervention pediatric practices nationally. Parents were asked to report if during the visit did anyone ask if they smoke cigarettes. A generalized linear mixed model was used to estimate the effect of black vs white race on asking parents about cigarette smoking. RESULTS: Among 17,692 parents screened at the exit interview, the proportion of black parents who were current smokers (16%) was lower than the proportion of white parents who smoked (20%) (P < .001). In control group practices, black parents were more likely to be asked (adjusted risk ratio 1.23; 95% confidence interval 1.08, 1.40) about cigarette smoking by pediatricians than whites. In intervention group practices both black and white parents were more likely to be asked about smoking than those in control practices and there was no significant difference between black and white parents in the likelihood of being asked (adjusted risk ratio 1.01; 95% confidence interval 0.93, 1.09). CONCLUSIONS: Although a smaller proportion of black parents in control practices smoked than white, black parents were more likely to be asked by pediatricians about smoking. The CEASE intervention was associated with higher levels of screening for smoking for both black and white parents.
RCT Entities:
OBJECTIVE: To examine racial differences in rates of screening parents for cigarette smoking during pediatric outpatient visits and to determine if a parental tobacco control intervention mitigates racial variation in whether cigarette smoking is addressed. METHODS: As part of the Clinical Effort Against Secondhand Smoke Exposure (CEASE) randomized controlled trial, exit interviews were conducted with parents at 10 control and 10 intervention pediatric practices nationally. Parents were asked to report if during the visit did anyone ask if they smoke cigarettes. A generalized linear mixed model was used to estimate the effect of black vs white race on asking parents about cigarette smoking. RESULTS: Among 17,692 parents screened at the exit interview, the proportion of black parents who were current smokers (16%) was lower than the proportion of white parents who smoked (20%) (P < .001). In control group practices, black parents were more likely to be asked (adjusted risk ratio 1.23; 95% confidence interval 1.08, 1.40) about cigarette smoking by pediatricians than whites. In intervention group practices both black and white parents were more likely to be asked about smoking than those in control practices and there was no significant difference between black and white parents in the likelihood of being asked (adjusted risk ratio 1.01; 95% confidence interval 0.93, 1.09). CONCLUSIONS: Although a smaller proportion of black parents in control practices smoked than white, black parents were more likely to be asked by pediatricians about smoking. The CEASE intervention was associated with higher levels of screening for smoking for both black and white parents.
Authors: Dennis R Trinidad; Eliseo J Pérez-Stable; Martha M White; Sherry L Emery; Karen Messer Journal: Am J Public Health Date: 2011-02-17 Impact factor: 9.308
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