Adolescent Smoking Cessation in Pediatric Primary Care

This is a study of the effectiveness of adolescent smoking cessation interventions in
pediatric primary care settings. Our specific aims are to:

1. Demonstrate providers' fidelity to guidelines for tobacco counseling and delivery of
cessation interventions using practice system changes over time, (including systematic
screening using charting tools and linkages to adjunct materials, including self-help
handouts and Internet resources); and

2. Assess the impact of primary care provider counseling interventions on adolescent
smoking cessation.

We hypothesize that adolescents who receive guidelines-based clinician-delivered smoking
cessation counseling at primary care visits will be more likely to make quit attempts and
more likely to remain abstinent (with better long term cessation rates) at 6 and 12 months
after intervention, compared to those who do not receive interventions. In addition, we
hypothesize that successful referral to stage-based self-help adjuncts, and more adjunct use
will be associated with more quit attempts and better long-term cessation rates.

We will evaluate provider interventions in up to 120 pediatric practices, recruited from the
American Academy of Pediatric's Pediatric Research in Office Settings (PROS) practice-based
research network. Adolescents presenting for care will complete a short baseline survey prior
to their doctor-visit, and a percentage of participants will be surveyed by phone 4‐6 weeks
after their visits to assess quit attempts and short-term cessation, and again at 6 and 12
months to evaluate long-term cessation outcomes. We will describe the patterns of smoking
among youth, and explore how much receiving interventions affects motivation, quitting,
abstinence/relapse attitudes, attitudes and use of adjunct strategies, and other smoking
behaviors for adolescent smokers.