An Intervention to Reduce Second Hand Smoke Exposure Among Pediatric Emergency Patients
An Intervention to Reduce Second Hand Smoke Exposure Among Pediatric Emergency Patients
This study will test the efficacy of a cessation intervention for caregivers in a large,
 inner-city Pediatric Emergency Department. The investigators will randomize 750 caregivers
 who smoke who present to our Pediatric Emergency Department with their child who has a Second
 Hand Smoke exposure-related illness to either one of two conditions: 1) Screening, Brief
 Intervention, and Assisted Referral to Treatment (SBIRT); or 2) Healthy Habits Control (HHC).
 The Screening, Brief Intervention, and Assisted Referral to Treatment condition will include
 a brief form of the Clinical Practice Guideline: Treating Tobacco Use and Dependence,
 motivational interviewing, engaging and personalized materials on the effects of smoking and
 Second Hand Smoke exposure, immediate access to caregivers' choice of cessation resources
 (e.g., Quitline, smokefree.gov, or txt2quit), a 12-week supply of nicotine replacement
 therapy and weekly booster materials for 12 weeks. The Healthy Habits Control program will be
 used as an attention control in which caregivers will receive instruction on healthy
 lifestyle choices to improve the child's health.
This study will test the efficacy of a cessation intervention for caregivers in a large,
 inner-city Pediatric Emergency Department. The proposed Screening, Brief Intervention, and
 Assisted Referral to Treatment will highlight the effects of Second Hand Smoke exposure on
 the child's health. the investigators will randomize 750 caregivers who smoke who present to
 our Pediatric Emergency Department with their child who has a Second Hand Smoke exposure
 related illness to either one of two conditions: 1) Screening, Brief Intervention, and
 Assisted Referral to Treatment; or 2) Healthy Habits Control. The Screening, Brief
 Intervention, and Assisted Referral to Treatment condition will use components shown to be
 effective in the out-patient setting but not yet tested in the Pediatric Emergency Department
 setting. It will include a brief form of the Clinical Practice Guideline: Treating Tobacco
 Use and Dependence, motivational interviewing, engaging and personalized materials on the
 effects of smoking and Second Hand Smoke exposure, immediate access to caregivers' choice of
 cessation resources (e.g., Quitline, smokefree.gov, or txt2quit), a 12-week supply of
 nicotine replacement therapy and weekly booster materials for 12 weeks. The Healthy Habits
 Control program has been previously developed and used in the out-patient setting, and will
 be used as an attention control in which caregivers will receive instruction on healthy
 lifestyle choices to improve their child's health. Cessation assistance will be offered at
 the study's conclusion. If effective, the Screening, Brief Intervention, and Assisted
 Referral to Treatment model could be routinely used in the Pediatric Emergency Department
 setting, which could reach at least one million smokers a year, and could result in
 significant reductions in caregivers' tobacco use, Second Hand Smoke exposure related
 pediatric illness, and costs in this population. In addition, the investigators' results will
 inform the conduct of public health research efforts aimed at adults via the Pediatric
 Emergency Department.
Inclusion Criteria:Eligible participants must:

 1. be > age 18;

 2. be accompanying a child 0-17 years of age who is presenting to the Pediatric Emergency
 Department with:

 -  a stable condition, that is, patients who are not critically ill and do not
 require immediate treatment and intervention by the Pediatric Emergency
 Department practitioner and

 -  a potentially Second Hand Smoke exposure related chief complaint (such as
 wheezing, difficulty breathing, cough) as outlined by the U.S. Surgeon General;45

 3. be a daily smoker;

 4. have currently or recently smoked inside their home;

 5. speak and read English, and

 6. have a permanent address and a working cell or landline number.

 7. Live within a 50 mile radius.

 8. Child is a non-smoker.

 Exclusion Criteria: Caregivers will be excluded if

 1. their child has a tracheostomy or

 2. if the caregivers are tobacco chewers only,

 3. if the caregivers are using pharmacologic cessation treatment,

 4. or plan to move within the study period.