Online Program

Pediatrician delivery of a teen tobacco cessation intervention

Monday, November 2, 2015

Julie Gorzkowski, MSW, Julius B Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, IL
Regina M. Shaefer, MPH, Julius B Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, IL
Kristen Kaseeska, BA, Julius B Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, IL
Margaret Wright, PhD, Department of Research, American Academy of Pediatrics, Elk Grove Village, IL
Jonathan Klein, MD, MPH, American Academy of Pediatrics, Elk Grove Village, IL
Background: Pediatricians are a trusted source of health information for teens, and should be trained to deliver tobacco cessation interventions during clinical visits. The PHS 5As (Ask-Advise-Assess-Assist-Arrange) intervention has shown success with adult smokers; PHS has called for research on its use with teens.

Method: 142 pediatric practices in the American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) practice based research network participated in a study of a teen-focused adaptation of the 5As. Teens completed a baseline survey during an office visit and a phone interview 4-6 weeks later. Chi-square analyses assessed teen-reported receipt of tobacco screening and counseling from 5As-trained pediatricians, compared to pediatricians trained in a media use intervention. Multivariable regressions examined predictors of teen receipt of tobacco screening/counseling.

Results: In data from 1175 teens (both smokers and non-smokers), 5As-trained (vs. comparison condition) pediatricians were more likely to Ask about smoking (72% v 52%) and Advise against smoking (71% v 55%). In data from 533 teen smokers, 5As-trained pediatricians were more likely to Assess quit-readiness (62% v 34%) and Assist with quitting (57% v 26%) (all ᵪ2 p<0.001). Multivariable logistic regressions showed that teens with a 5As-trained pediatrician were twice as likely to be screened for tobacco (OR=2.33, 95% CI=1.79-3.03) and teen smokers were more than three times as likely to be counseled about smoking (OR=3.11, 95% CI-2.04-4.76).

Conclusion: Our intervention improves delivery of tobacco cessation interventions by pediatricians. Pediatric training may help reinforce public health and other tobacco control interventions in promoting tobacco cessation in communities.

Learning Areas:

Clinical medicine applied in public health
Provision of health care to the public
Public health or related research

Learning Objectives:
Describe pediatrician delivery of a teen-focused adaptation of the Public Health Service (PHS) 5As tobacco cessation intervention during a national study of primary care visits. Discuss the importance of training pediatric health providers in tobacco cessation interventions as a method of reinforcing and promoting tobacco cessation efforts in communities.

Keyword(s): Tobacco Use, Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a research manager at the American Academy of Pediatrics, managing multiple federally-funded health services research studies related to tobacco control. Among my interests are adolescent health research and tobacco control research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.