PEDIATRICS Vol. 115 No. 4 April 2005, pp. 981-989 (doi:10.1542/peds.2004-0981)
Teen Reach: Outcomes From a Randomized, Controlled Trial of a Tobacco Reduction Program for Teens Seen in Primary Medical Care
* Center for Health Research, Kaiser Permanente, Portland, Oregon
Oregon Research Institute, Eugene, Oregon
University of Rhode Island, Kingston, Rhode Island
Objective. To test the long-term efficacy of brief counseling plus a computer-based tobacco intervention for teens being seen for routine medical care.
Methods. Both smoking and nonsmoking teens, 14 to 17 years of age, who were being seen for routine visits were eligible for this 2-arm controlled trial. Staff members approached teens in waiting rooms of 7 large pediatric and family practice departments within a group-practice health maintenance organization. Of 3747 teens invited at 
1 visits, 2526 (67%) consented and were randomized to tobacco intervention or brief dietary advice. The tobacco intervention was individually tailored on the basis of smoking status and stage of change. It included a 30-second clinician advice message, a 10-minute interactive computer program, a 5-minute motivational interview, and up to two 10-minute telephone or in-person booster sessions. The control intervention was a 5-minute motivational intervention to promote increased consumption of fruits and vegetables. Follow-up smoking status was assessed after 1 and 2 years.
Results. Abstinence rates after 2 years were significantly higher for the tobacco intervention arm, relative to the control group, in the combined sample of baseline smokers and nonsmokers (odds ratio [OR]: 1.23; 95% confidence interval [CI]: 1.03–1.47). Treatment effects were particularly strong among baseline self-described smokers (OR: 2.42; 95% CI: 1.40–4.16) but were not significant for baseline nonsmokers (OR: 1.25; 95% CI: 0.97–1.61) or for those who had "experimented" in the past month at baseline (OR: 0.95; 95% CI: 0.45–1.98).
Conclusions. Brief, computer-assisted, tobacco intervention during routine medical care increased the smoking cessation rate among self-described smokers but was less effective in preventing smoking onset.
Key Words: tobacco • adolescents • intervention • cessation • primary care
Abbreviations: OR, odds ratio • CI, confidence interval • GEE, generalized estimating equations • PTC, Pathways to Change
Accepted Sep 1, 2004.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  A. V. Peterson Jr, K. A. Kealey, S. L. Mann, P. M. Marek, E. J. Ludman, J. Liu, and J. B. Bricker Group-Randomized Trial of a Proactive, Personalized Telephone Counseling Intervention for Adolescent Smoking Cessation J Natl Cancer Inst, October 21, 2009; 101(20): 1378 - 1392. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Kealey, E. J. Ludman, P. M. Marek, S. L. Mann, J. B. Bricker, and A. V. Peterson Design and Implementation of an Effective Telephone Counseling Intervention for Adolescent Smoking Cessation J Natl Cancer Inst, October 21, 2009; 101(20): 1393 - 1405. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Barnet, J. Liu, M. DeVoe, A. K. Duggan, M. A. Gold, and E. Pecukonis Motivational Intervention to Reduce Rapid Subsequent Births to Adolescent Mothers: A Community-Based Randomized Trial Ann. Fam. Med, September 1, 2009; 7(5): 436 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-K. Myung, D. D. McDonnell, G. Kazinets, H. G. Seo, and J. M. Moskowitz Effects of Web- and Computer-Based Smoking Cessation Programs: Meta-analysis of Randomized Controlled Trials Arch Intern Med, May 25, 2009; 169(10): 929 - 937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. L. Olson, C. A. Gaffney, V. A. Hedberg, and G. R. Gladstone Use of Inexpensive Technology to Enhance Adolescent Health Screening and Counseling Arch Pediatr Adolesc Med, February 1, 2009; 163(2): 172 - 177. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Muller-Riemenschneider, A Bockelbrink, T Reinhold, A Rasch, W Greiner, and S N Willich Long-term effectiveness of behavioural interventions to prevent smoking among children and youth Tob. Control, October 1, 2008; 17(5): 301 - 302. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L. Backinger, C. N. Michaels, A. M. Jefferson, P. Fagan, A. L. Hurd, and R. Grana Factors associated with recruitment and retention of youth into smoking cessation intervention studies--a review of the literature Health Educ. Res., April 1, 2008; 23(2): 359 - 368. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Pbert, A. J. Flint, K. E. Fletcher, M. H. Young, S. Druker, and J. R. DiFranza Effect of a Pediatric Practice-Based Smoking Prevention and Cessation Intervention for Adolescents: A Randomized, Controlled Trial Pediatrics, April 1, 2008; 121(4): e738 - e747. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Robinson, K. M. Emmons, E. T. Moolchan, and J. S. Ostroff Developing Smoking Cessation Programs for Chronically Ill Teens: Lessons Learned from Research with Healthy Adolescent Smokers J. Pediatr. Psychol., March 1, 2008; 33(2): 133 - 144. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. P. Tercyak, M. T. Britto, K. M. Hanna, P. J. Hollen, and M. M. Hudson Prevention of Tobacco Use Among Medically At-risk Children and Adolescents: Clinical and Research Opportunities in the Interest of Public Health J. Pediatr. Psychol., March 1, 2008; 33(2): 119 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Bancej, J. O'Loughlin, R. W Platt, G. Paradis, and A. Gervais Smoking cessation attempts among adolescent smokers: a systematic review of prevalence studies Tob. Control, December 1, 2007; 16(6): e8 - e8. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Jason, S. B. Pokorny, M. Adams, Y. Hunt, P. Gadiraju, T. Morello, M. Schoeny, and C. Dinwiddie Youth Caught in Violation of Tobacco Purchase, Use, and Possession Laws: Education Versus Fines Behav Modif, November 1, 2007; 31(6): 713 - 731. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Jull How to write a commentary an editor's perspective Evid. Based Nurs., October 1, 2007; 10(4): 100 - 103. [Full Text] [PDF]
|
|
|
|
|
|
M. A. Hellems, M. J. Gurka, and G. F. Hayden Statistical Literacy for Readers of Pediatrics: A Moving Target Pediatrics, June 1, 2007; 119(6): 1083 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. N. Hylkema, P. J. Sterk, W. I. de Boer, and D. S. Postma Tobacco use in relation to COPD and asthma Eur. Respir. J., March 1, 2007; 29(3): 438 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J. Norman, M. A. Adams, K. J. Calfas, J. Covin, J. F. Sallis, J. S. Rossi, C. A. Redding, J. Cella, and K. Patrick A Randomized Trial of a Multicomponent Intervention for Adolescent Sun Protection Behaviors Arch Pediatr Adolesc Med, February 1, 2007; 161(2): 146 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Pbert, K. E. Fletcher, A. J. Flint, M. H. Young, S. Druker, and J. DiFranza Smoking Prevention and Cessation Intervention Delivery by Pediatric Providers, as Assessed With Patient Exit Interviews Pediatrics, September 1, 2006; 118(3): e810 - e824. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Werch, J. L. Grenard, J. Burnett, J. A. Watkins, S. Ames, and E. Jobli Translation as a Function of Modality: The Potential of Brief Interventions Eval Health Prof, March 1, 2006; 29(1): 89 - 125. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Lancaster Clinician advice, an interactive computer program, and motivational counselling increased smoking cessation in teens Evid. Based Med., October 1, 2005; 10(5): 144 - 144. [Full Text] [PDF]
|
|
|
|
|
|
D. Kingston Clinician advice, an interactive computer program, and motivational counselling during routine medical visits increased reported smoking abstinence among teens Evid. Based Nurs., October 1, 2005; 8(4): 105 - 105. [Full Text] [PDF]
|
|
eLetters:
Read all eLetters
- The efficacy of Transtheoretical Model expert systems in adolescents
- Paul Aveyard, et al.
- Pediatrics Online, 18 Jan 2006 [Full text]
