MOTIVATING PARENTS OF KIDS WITH ASTHMA TO QUIT SMOKING

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DESCRIPTION (adapted from investigator's abstract): This application will contrast the efficacy of two theoretically-based smoking cessation interventions for parents of children with asthma, and compare key mechanisms of behavior change. Implementing effective smoking cessation for this population has the potential to effect changes in health outcomes for both the adult smoker and child with asthma. Smokers will be recruited into an in- home, individualized asthma education program, which is part of their health insurance carrier's standard of care. They will be randomized to one of two treatment conditions employing constructs from a larger social cognitive theoretical framework. The first, Behavioral Action Model (BAM), is based on AHCRP guidelines and emphasizes goal-setting and problem-solving skills to enhance self-efficacy to quit smoking. The second, Precaution Adoption Model (PAM), is tailored to the smokers's degree of readiness to quit, and incorporates specific biomarker feedback (level of environmental tobacco smoke in the home, and carbon monoxide and cotinine testing) to increase perception of risk of smoke exposure. All smokers will receive the nicotine patch if they are ready to quit, and all intervention components will be delivered by respiratory therapists in the home. Analyses will examine: 1) quit rates, level of environmental tobacco smoke in the home, and motivation to quit between treatment groups throughout the 12 months post-treatment; 2) strength of mediators of behavior change between and within each condition; and 3) relations between smoking outcomes and asthma morbidity variables in children post-treatment.