Abstract B62: Tailored parental cessation delivered concurrently with tobacco prevention in children enrolled in urban and rural southern elementary schools
Authors: Tingen Martha S. , Andrews Jeannette O. , Heath Janie , Williams Lovoria B. , Schroeder Carsten , Dainer Paul , Khleif Samir N. , Waller Jennifer L. 
Published: May 2016

Purpose: Socioeconomically disadvantaged populations have higher tobacco use rates resulting in more disparate cancer outcomes. The effectiveness of tailored cessation interventions in parent/caregiver smokers delivered within an elementary school setting while their child is concurrently enrolled in a smoking prevention program has been minimally explored.

Procedures/Methods: During a randomized controlled trial (RCT) that included children and one parent/caregiver per child, parent/caregiver smokers were offered cessation in years 1 and 2 (if relapsed/refused in year 1) at their child's respective school or local community setting. Parent/caregiver smokers in the intervention group received tailored cessation including eight individual face-to-face motivational interviewing sessions with a matched gender and/or racial/ethnically similar counselor and eight weeks of nicotine replacement therapy. The control parents/caregivers who smoked received information for contacting the state toll-free Tobacco Quit Line and tailored (based on race/ethnicity) written materials to assist with cessation. Children in the intervention arm received concurrently a tobacco prevention curriculum, Botvin's LifeSkills Training, over the same time period in years 1 & 2. The control group children received the standard health education curriculum for public school systems. This study reports on the effectiveness of the parent/caregiver cessation intervention including outcomes of self-reported smoking status (percentages) and the biological measure, salivary cotinine (ng/ml), both obtained at baseline, end of treatment (EOT)/year 2, and in year 4 follow-up.

Results/Summary: Parent/Caregiver smokers (n=110) comprised 24.6% of the enrolled (n=447) parent/caregiver sample. The parent/caregiver smokers were predominantly female (81%), mean age 37.2 yrs. (SD 11.1); 37% Black; 54% had &lt; a high school education; 54% earned &lt; $20,000 annually; and 61% were covered by Medicaid and/or Medicare. Using repeated measures, binomial generalized estimating equation or mixed models, differences over time between parents/caregivers in the intervention and control groups were found for quitting smoking and cotinine levels. Parents/caregivers in the intervention group [EOT: 6.5% (SE=5.7%), Yr.4: 40.6%(SE=5.7%)] showed a larger increase in quitting smoking over time than the control group [EOT: 0.0%(SE=6.5%), Yr.4: 13.2%(SE=6.4%)] (F=4.82, p=0.0306). For cotinine (F=5.72, p=0.0039), the intervention group showed a decrease from baseline (239.9,[SE=1.3]) to EOT (99.3,[SE=1.4]) and then maintenance through Yr.4 (109.6,[SE=1.4]), while the control group showed increases from baseline (221.1,[SE=1.4]) to EOT (239.0,[SE=1.4]) to Yr.4 (325.8,[SE=14]).

Conclusions: This study provides beginning evidence that tailored cessation offered to parents/caregivers in their child's school setting while their child is enrolled in tobacco prevention classes may be an avenue for more robust success in quitting smoking. Such a strategy may serve as an initial step for improving public health and for decreasing tobacco-related disparities and associated poor health outcomes among disadvantaged populations. By improving parent's/caregiver's success and maintenance of tobacco cessation, a joint program may reinforce the child's resistance to the lure of tobacco products and may also potentially decrease his or her secondhand smoke exposure within the home.

Citation Format: Martha S. Tingen, Jeannette O. Andrews, Janie Heath, Lovoria B. Williams, Carsten Schroeder, Paul Dainer, Samir N. Khleif, Jennifer L. Waller. Tailored parental cessation delivered concurrently with tobacco prevention in children enrolled in urban and rural southern elementary schools. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B62.