Smoking Cessation in Pediatric Pratice: Phase 1

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DESCRIPTION (provided by applicant): More than three million adolescents in the United States smoke cigarettes. Although there has been considerable research on smoking prevention for children and on clinical smoking cessation interventions for adults, few studies examine smoking cessation interventions for youth. The University of Rochester--in collaboration with the American Academy of Pediatrics-Pediatrics Research in Office Settings (PROS) practice-based research network of more than 1,700 clinicians in 601 primary care pediatric practices--proposes pilot studies of tobacco cessation counseling interventions for adolescents in primary care pediatric settings. Our long-term goal is to improve the quality of clinical preventive services in PBRN settings. Our specific aims are to: 1a) pilot procedures for recruitment and randomization of PROS practices, 1b) field trial/pilot PROS practitioner cessation counseling and practices' enrollment of adolescent patients; and, 2) assess the feasibility of pediatric clinician referral of adolescent patients to internet-based adjuncts for smoking cessation. We will pilot recruitment and training using the Public Health Service Guideline 5A's model in 10 PROS practice sites; assess adolescent enrollment and screening procedures with 1,000 adolescents, and survey 100 smokers two to three weeks after their visits to assess the interventions and at three months to provide preliminary estimates of cessation outcomes. We will field test measures, describe the patterns of smoking among youth, and explore how interventions affect motivation, quitting, abstinence, attitudes, and smoking behaviors. The PROS network offers the unique opportunity to develop interventions in collaboration with clinicians who will actually use them. This study will develop methods for future larger scale studies and will add to our understanding of the process of implementation of adolescent smoking cessation in primary care practice. If effective, these interventions will have broad public health implications for reducing smoking prevalence among youth.