Perceptions of Parental Tobacco Dependence Treatment Among a Children’s Hospital Staff

Abstract

A B S T R A C TOBJECTIVES: To assess employee support for and knowledge of smoking cessation programs for patients' parents and staff and employees' level of comfort discussing smoking with patients and their families before and during a hospital-wide study of a tobacco cessation and/or exposure reduction program for inpatients' parents who smoke. METHODS:Clinical staff were invited to complete online surveys at the beginning of and 19 months into a randomized controlled trial to test the efficacy of an inpatient tobacco cessation and exposure reduction program for parents of hospitalized children. The program included educating pediatric inpatient clinical staff about available resources, such as the Colorado QuitLine, and smoking cessation interventions for the parents of hospitalized children. Clinical staff were recruited via e-mail listservs, a weekly e-mail newsletter, and posted flyers. Baseline and midstudy results were compared, and x 2 tests were performed. RESULTS:At the baseline, 192 clinical staff responded; 235 responded midstudy. At the baseline and midstudy, at least 90% of the respondents believed that the hospital should support parents in quitting smoking, although the support for free nicotine replacement therapy was low (27% at the baseline to 35% at midstudy). One-fifth of the respondents were uncomfortable discussing smoking; this proportion decreased after educational interventions. Knowledge about hospital cessation resources had also increased at midstudy. CONCLUSIONS:There was strong support for helping parents and staff quit smoking. Comfort among clinical staff in addressing tobacco dependence in patients and families and awareness of cessation resources increased over the course of the study.

Provision of free nicotine replacement therapy to parental smokers in the pediatric emergency setting

“…Although rates of smoking cessation counseling in pediatric primary care settings are increasing, rates of recommending or prescribing pharmacological cessation therapy remain low at 15% and 3%, respectively 5 . Reasons for low prescription rates by pediatric providers include concerns about lack of knowledge and scope of practice, due to feeling uncomfortable in prescribing medications for parents who are not their patients 5 - 7 . Nevertheless, the American Academy of Pediatrics strongly encourages pediatric practitioners to prescribe pharmacological cessation medications in conjunction with counseling during children's healthcare visits to help parents quit smoking 2 , 3 .…”

Barriers to Tobacco Cessation for Caregivers of Hospitalized Children: Perspectives of Pediatric Hospitalists

“…6 Caregivers are generally receptive to tobacco cessation programs during their child' s hospitalization. 6,8 To our knowledge, authors of only one study have investigated the perspectives of pediatric inpatient staff (eg, physicians, physician trainees, nurses, respiratory therapists) on tobacco cessation programs for caregivers. Although preliminary support for such programs was indicated in the study, 8 to date, the pediatric hospital remains underused for provision of this evidencebased care, and barriers remain poorly understood.…”

Home Smoke Exposure and Health‐Related Quality of Life in Children with Acute Respiratory Illness

“…Further, prior studies have demonstrated both the feasibility and the effectiveness of smoking cessation interventions in hospitalized children. [27][28][29][30] Unfortunately, however, SHS exposure is often not documented at the time of hospitalization, and many opportunities to intervene are missed. 25,31 Thus, there is a need for improved strategies to reliably identify and intervene on SHS-exposed children in the hospital setting.…”

“…Similar to scores representing baseline health, admission scores were lower across all four conditions for SHS-exposed children. Only children with croup, however, had (22) 559 (24) 316 (14) 663 42304 (19) 402 (26) 206 (13) 249 (34) 207 (29) 157 (22) 110 ( 740 (32) 342 (15) 563 (24) 415 (26) 502 (32) 255 (16) 409 (26) 249 (34) 238 (33) 87 (12) 154 (21 714 (31) 423 (18) 156 (10) 645 (41) 482 (30) 298 (19) 84 (12) 287 (39) 232 (32) 125 (17) .6 a Comorbidities were assessed using the Pediatric Medical Complexity Algorithm (see reference 10); Pediatric Respiratory Illness Measurement System eligibility criteria excluded children with immunodeficiency, cystic fibrosis, a history of prematurity <32 weeks, chronic neuromuscular disease, cardiovascular disease, pulmonary diseases (other than asthma), and moderate to severe developmental delay. Data are presented as no.…”