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Pediatric-Based Smoking Cessation Intervention for Low-Income Women
A Randomized Trial
Susan J. Curry, PhD;
Evette J. Ludman, PhD;
Elinor Graham, MD, MPH;
James Stout, MD, MPH;
Louis Grothaus, MA;
Paula Lozano, MD, MPH
Arch Pediatr Adolesc Med. 2003;157:295-302.
Background Continued high rates of smoking among socioeconomically disadvantaged women lead to increases in children's health problems associated with exposure to tobacco smoke. The pediatric clinic is a "teachable setting" in which to provide advice and assistance to parents who smoke.
Objective To evaluate a smoking cessation intervention for women.
Design Two-arm (usual care vs intervention) randomized trial.
Setting Pediatric clinics serving an ethnically diverse population of low-income families in the greater Seattle, Wash, area.
Intervention During the clinic visit, women received a motivational message from the child's clinician, a guide to quitting smoking, and a 10-minute motivational interview with a nurse or study interventionist. Women received as many as 3 outreach telephone counseling calls from the clinic nurse or interventionist in the 3 months following the visit.
Participants Self-identified women smokers (n = 303) whose children received care at participating clinics.
Main Outcome Measure Self-reported abstinence from smoking 12 months after enrollment in the study, defined as not smoking, even a puff, during the 7 days prior to assessment.
Results Response rates at 3 and 12 months were 80% and 81%. At both follow-ups, abstinence rates were twice as great in the intervention group as in the control group (7.7% vs 3.4% and 13.5% vs 6.9%, respectively). The 12-month difference was statistically significant.
Conclusions A pediatric clinic smoking cessation intervention has long-term effects in a socioeconomically disadvantaged sample of women smokers. The results encourage implementation of evidence-based clinical guidelines for smoking cessation in pediatric practice.
From the Center for Health Studies, Group Health Cooperative (Drs Curry, Ludman, and Lozano and Mr Grothaus) and the Health Research and Policy Centers (Dr Curry), University of Illinois at Chicago; and the Department of Pediatrics, University of Washington, Seattle (Drs Graham, Stout, and Lozano).
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