Sustaining Cessation in Smokers With Kids With Asthma

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): This application is a renewal of our prior NHLBI grant, "Motivating the Parents of Kids with Asthma to Quit Smoking." This study compared two nurse-delivered home-based smoking cessation interventions for low income caregivers of children receiving asthma treatment; one that focused on augmenting risk perception through the provision of Motivational Interviewing and biomarker feedback (PAM), and one that focused on building self-efficacy using AHRQ guidelines (BAM). PAM achieved significantly greater quit rates than BAM at a 2 month follow-up, but both groups had high relapse rates by 6-months. The first aim of the current study is to utilize our previously demonstrated smoking cessation intervention (PAM) to examine the cognitive, affective, and behavioral processes hypothesized to underlie the Teachable Moment in smokers with kids who had a recent asthma exacerbation vs. smokers with healthy kids. Few, if any studies, have conducted a systematic evaluation of the constructs hypothesized to underlie the Teachable Moment, nor have they included the appropriate comparison groups of individuals not experiencing a teachable moment. Our second aim attempts to sustain the excellent short-term quit rates we found in our first study by testing whether supplementing PAM with a telephone-based intervention improves and sustains quitting more than PAM plus contact control among parents of kids with asthma. The telephone counseling will be theory based, targeting the constructs associated with quitting in our first study (perceived risk, precaution effectiveness, self-efficacy). To our knowledge, no studies have utilized telephone counseling to motivate smoking cessation in the parents of kids with asthma. Our primary outcomes: point prevalence abstinence, relapse, ETS reduction, asthma morbidity, and health care utilization. We will also examine mediators and moderators. Our study has public health significance because it will be conducted in the "real world," during the course of the child's asthma treatment, proactively reaching smokers who may not otherwise quit.