Tregony Simoneau1, Jessica P Hollenbach2,3, Christine R Langton3, Chia-Ling Kuo4, Michelle M Cloutier2. 1. Department of Pediatrics, Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America. 2. Department of Pediatrics, UConn Health, Farmington, Connecticut, United States of America. 3. Asthma Center, Connecticut Children's Medical Center, Hartford, Connecticut, United States of America. 4. Department of Community Medicine and Health Care, Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut, United States of America.
Abstract
OBJECTIVE: Pediatric providers play an important role in parental and youth smoking cessation. The goal of this study was to understand smoking cessation attitudes of parents and the behaviors, confidence and self-efficacy of pediatricians related to providing smoking cessation counseling to parents and youth. METHODS: A mixed methods study was conducted in a convenience sample of families (n = 1,549) and pediatric primary care clinicians (n = 95) in Connecticut using surveys and focus groups from April, 2016 to January, 2017. RESULTS: The smoking rate (cigarettes or electronic cigarettes) among all households surveyed was 21%. Interest in quitting smoking was high (71%) and did not differ based on smoking amount, duration, type of community of residence (urban, rural, etc), or race/ethnicity. For example, compared to participants who smoked for <10 years, those who smoked ≥20 years had a similar interest in quitting (OR = 1.12; 95% CI: 0.85-1.48). Ninety percent of clinicians surveyed asked parents about their smoking behavior at least annually but 36% offered no smoking cessation counseling services or referral. Clinicians almost always reported counseling youth about the dangers of nicotine and tobacco use (99%), were more confident about counseling youth than parents (p<0.01) and reported low self-efficacy about smoking cessation and prevention counseling of parents and youth. Ninety-three percent of clinicians opined that electronic cigarettes were equally or more dangerous than cigarettes but 34% never counseled youth about the dangers of electronic cigarettes. CONCLUSIONS: Clinicians frequently screen parents about their smoking behaviors, but rarely provide smoking cessation counseling and express low confidence in this activity. Clinicians are more confident counseling youth than parents. Clinicians also recognize the dangers of electronic cigarettes, yet they infrequently counsel youth about these dangers.
OBJECTIVE: Pediatric providers play an important role in parental and youth smoking cessation. The goal of this study was to understand smoking cessation attitudes of parents and the behaviors, confidence and self-efficacy of pediatricians related to providing smoking cessation counseling to parents and youth. METHODS: A mixed methods study was conducted in a convenience sample of families (n = 1,549) and pediatric primary care clinicians (n = 95) in Connecticut using surveys and focus groups from April, 2016 to January, 2017. RESULTS: The smoking rate (cigarettes or electronic cigarettes) among all households surveyed was 21%. Interest in quitting smoking was high (71%) and did not differ based on smoking amount, duration, type of community of residence (urban, rural, etc), or race/ethnicity. For example, compared to participants who smoked for <10 years, those who smoked ≥20 years had a similar interest in quitting (OR = 1.12; 95% CI: 0.85-1.48). Ninety percent of clinicians surveyed asked parents about their smoking behavior at least annually but 36% offered no smoking cessation counseling services or referral. Clinicians almost always reported counseling youth about the dangers of nicotine and tobacco use (99%), were more confident about counseling youth than parents (p<0.01) and reported low self-efficacy about smoking cessation and prevention counseling of parents and youth. Ninety-three percent of clinicians opined that electronic cigarettes were equally or more dangerous than cigarettes but 34% never counseled youth about the dangers of electronic cigarettes. CONCLUSIONS: Clinicians frequently screen parents about their smoking behaviors, but rarely provide smoking cessation counseling and express low confidence in this activity. Clinicians are more confident counseling youth than parents. Clinicians also recognize the dangers of electronic cigarettes, yet they infrequently counsel youth about these dangers.
Authors: Jonathan P Winickoff; Susanne E Tanski; Robert C McMillen; Jonathan D Klein; Nancy A Rigotti; Michael Weitzman Journal: Pediatrics Date: 2005-04 Impact factor: 7.124
Authors: Jonathan P Winickoff; Robert C McMillen; Bronwen C Carroll; Jonathan D Klein; Nancy A Rigotti; Susanne E Tanski; Michael Weitzman Journal: Pediatrics Date: 2003-11 Impact factor: 7.124
Authors: Jennifer Irvin Vidrine; Sanjay Shete; Yumei Cao; Anthony Greisinger; Penny Harmonson; Barry Sharp; Lyndsay Miles; Susan M Zbikowski; David W Wetter Journal: JAMA Intern Med Date: 2013-03-25 Impact factor: 21.873