A Parental Smoking Cessation Intervention in the Pediatric Emergency Setting: A Randomized Trial.
A Parental Smoking Cessation Intervention in the Pediatric Emergency Setting: A Randomized Trial.
复制标题
儿科急诊环境中父母戒烟干预：一项随机试验。
DOI：
10.3390/ijerph17218151
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发表时间：
2020-11-04
影响因子：
--
通讯作者：
Gordon JS
中科院分区：
文献类型：
--
作者：
Mahabee-Gittens EM;Ammerman RT;Khoury JC;Tabangin ME;Ding L;Merianos AL;Stone L;Gordon JS
我们检查了基于儿科紧急就诊的筛查、简短干预和转诊治疗 (SBIRT) 条件与对照条件（健康习惯控制，HHC）的效果，以帮助父母吸烟者戒烟。我们招募了 750 名带着孩子到儿科急诊室就诊的父母吸烟者参加一项两组随机对照临床试验。 SBIRT 参与者接受了简短的戒烟指导、戒烟资源以及长达 12 周的尼古丁替代疗法 (NRT)。 HHC 参与者获得了健康生活方式的指导和资源。主要结果是六周（T1）和六个月（T2）时的点流行率戒烟情况。父母的平均年龄 (SD) 为 31.8 (7.7) 岁，其中 86.8% 为女性，52.7% 为黑人，64.6% 的收入≤15,000 美元。总体戒断率无统计学意义，T1 时两组均为 4.2%，T2 时 SBIRT 组和 HHC 组分别为 12.9% 和 8.3%。 SBIRT 与 HHC 参与者在 T1 时每日吸烟量相对于基线的中位数 (IQR) 减少量（−2 [−5, 0] 与 0 [−4, 0]，p = 0.0008）、T2 时相对于基线的中位数（IQR）减少（−4 [−9, -1] 与 -2 [−5, 0]，p = 0.0006）以及平均值上存在统计学显着差异 (SD) T2 时相对于基线的戒烟尝试次数（1.25 (6.5) vs. 0.02 (4.71)，p = 0.02）。接受 NRT 的 SBIRT 父母的自我报告戒烟率较高（83.3% vs. 50.9%，p = 0.04）。新颖地利用儿科紧急就诊进行戒烟干预，帮助父母戒烟。 SBIRT 组和 HHC 组的戒烟率几乎相同，这可能是由于父母对孩子健康的潜在担忧。在这种情况下的戒烟干预可能会给成人和儿童带来公共卫生益处。
We examined the efficacy of a pediatric emergency visit-based screening, brief intervention, and referral to treatment (SBIRT) condition compared to a control condition (Healthy Habits Control, HHC) to help parental smokers quit smoking. We enrolled 750 parental smokers who presented to the pediatric emergency setting with their child into a two-group randomized controlled clinical trial. SBIRT participants received brief cessation coaching, quitting resources, and up to 12-weeks of nicotine replacement therapy (NRT). HHC participants received healthy lifestyle coaching and resources. The primary outcome was point-prevalence tobacco abstinence at six weeks (T1) and six months (T2). The mean (SD) age of parents was 31.8 (7.7) years, and 86.8% were female, 52.7% were Black, and 64.6% had an income of ≤$15,000. Overall abstinence rates were not statistically significant with 4.2% in both groups at T1 and 12.9% and 8.3% in the SBIRT and HHC groups, respectively, at T2. There were statistically significant differences in SBIRT versus HHC participants on the median (IQR) reduction of daily cigarettes smoked at T1 from baseline (−2 [−5, 0] versus 0 [−4, 0], p = 0.0008),at T2 from baseline (−4 [−9, −1] vs. −2 [−5, 0], p = 0.0006), and on the mean (SD) number of quit attempts at T2 from baseline (1.25 (6.5) vs. 0.02 (4.71), p = 0.02). Self-reported quitting rates were higher in SBIRT parents who received NRT (83.3% vs. 50.9%, p = 0.04). The novel use of the pediatric emergency visit to conduct cessation interventions helped parents quit smoking. The near equivalent abstinence rates in both the SBIRT and HHC groups may be due to underlying parental concern about their child’s health. Cessation interventions in this setting may result in adult and pediatric public health benefits.
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