Adolescent Smoking Cessation in Pediatric Primary Care
Condition: Tobacco Cessation; Media Use
Study type: Interventional

Summary: 
      This is a study of the effectiveness of adolescent smoking cessation interventions in
      pediatric primary care settings. Our specific aims are to:

        1. Demonstrate providers' fidelity to guidelines for tobacco counseling and delivery of
           cessation interventions using practice system changes over time, (including systematic
           screening using charting tools and linkages to adjunct materials, including self-help
           handouts and Internet resources); and

        2. Assess the impact of primary care provider counseling interventions on adolescent
           smoking cessation.

      We hypothesize that adolescents who receive guidelines-based clinician-delivered smoking
      cessation counseling at primary care visits will be more likely to make quit attempts and
      more likely to remain abstinent (with better long term cessation rates) at 6 and 12 months
      after intervention, compared to those who do not receive interventions. In addition, we
      hypothesize that successful referral to stage-based self-help adjuncts, and more adjunct use
      will be associated with more quit attempts and better long-term cessation rates.

      We will evaluate provider interventions in up to 120 pediatric practices, recruited from the
      American Academy of Pediatric's Pediatric Research in Office Settings (PROS) practice-based
      research network. Adolescents presenting for care will complete a short baseline survey prior
      to their doctor-visit, and a percentage of participants will be surveyed by phone 4-6 weeks
      after their visits to assess quit attempts and short-term cessation, and again at 6 and 12
      months to evaluate long-term cessation outcomes. We will describe the patterns of smoking
      among youth, and explore how much receiving interventions affects motivation, quitting,
      abstinence/relapse attitudes, attitudes and use of adjunct strategies, and other smoking
      behaviors for adolescent smokers.
    


Intervention name(s): 5A's Model; Media Use Assessment
Intervention type(s): Other; Other
Intervention description(s): The smoking cessation intervention is based on the 5A's model, which includes the following elements:
Ask if the patient smokes.
Advise every patient to quit.
Assess readiness to quit.
Assist in quitting and finding services.
Arrange for cessation services and follow-up.; The media use assessment (control condition) is based in part on the American Academy of Pediatrics policy statement on children and media, published in the November 2010 issue of Pediatrics. This assessment includes suggested questions on how much media per day is used and whether or not the adolescent has a television or Internet access in his/her bedroom. The adolescent will complete a one-page Media Use assessment form for this purpose, which will set the stage for relevant anticipatory guidance.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Tobacco; Tobacco Prevention; Tobacco Cessation; 5A's Model; Adolescence; Media Use