Published online April 1, 2008
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e738-e747 (doi:10.1542/peds.2007-1029)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Google Scholar
Right arrow Articles by Pbert, L.
Right arrow Articles by DiFranza, J. R.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pbert, L.
Right arrow Articles by DiFranza, J. R.
Related Collections
Right arrow Office Practice

ARTICLE

Effect of a Pediatric Practice-Based Smoking Prevention and Cessation Intervention for Adolescents: A Randomized, Controlled Trial

Lori Pbert, PhDa, Alan J. Flint, MD, MPHb, Kenneth E. Fletcher, PhDc,d,e, Martin H. Young, PhDf, Susan Druker, MAa and Joseph R. DiFranza, MDd

a Division of Preventive and Behavioral Medicine
c Department of Psychiatry
d Department of Family Medicine and Community Health
e Graduate School of Nursing
f Division of Developmental and Behavioral Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts
b Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts

OBJECTIVE. The purpose of this work was to determine whether a pediatric practice-based smoking prevention and cessation intervention increases abstinence rates among adolescents.

METHODS. Eight pediatric primary care clinics were randomly assigned to either intervention or usual care control condition. The provider- and peer-delivered intervention tested was based on the 5A model recommended by the US Public Health Service clinical practice guidelines and the American Academy of Pediatrics and consisted of brief counseling by the pediatric provider followed by 1 visit and 4 telephone calls by older peer counselors aged 21 to 25 years. A consecutive sample of patients aged 13 to 17 years scheduled for an office visit was eligible regardless of smoking status. Of 2711 patients who agreed to participate, 2709 completed baseline assessments, and 2700 (99.6%) and 2690 (99.2%) completed 6- and 12-month assessments, respectively.

RESULTS. Compared with the usual care condition, nonsmokers who received the provider- and peer-delivered intervention were significantly more likely to self-report having remained abstinent at 6-month and 12-month follow-up; smokers who received the provider- and peer-delivered intervention were more likely to report having quit at the 6-month but not the 12-month follow-up. A number of adolescent characteristics (eg, age, peer smoking, tobacco dependence, and susceptibility) were found to be predictive of abstinence at follow-up.

CONCLUSIONS. A pediatric practice-based intervention delivered by pediatric providers and older peer counselors proved feasible and effective in discouraging the initiation of smoking among nonsmoking adolescents for 1 year and in increasing abstinence rates among smokers for 6 months.

Key Words: adolescents • pediatric provider • smoking cessation • smoking prevention

Abbreviations: PPDI—provider- and peer-delivered intervention • UC—usual care • CDI—Children's Depression Inventory • ADD—attention deficit disorder • ADHD—attention-deficit/hyperactivity disorder • mFTQ—modified Fagerström Tolerance Questionnaire • HONC—Hooked on Nicotine Checklist • OR—odds ratio • CI—confidence interval

Accepted Aug 31, 2007.




This article has been cited by other articles:


Home page
 JWatch GeneralHome page
Smoking Prevention Intervention in Adolescents
Journal Watch (General), May 8, 2008; 2008(508): 5 - 5.
[Full Text]