Computer-Based Program to Facilitate Readiness and Motivation for Smoking Cessation

Tobacco use is widely recognized as the most preventable cause of cancer in the United
States. Furthermore, tobacco use is responsible for 30% of all cancer-related deaths in the
United States. Although practice guidelines recommend that clinicians address tobacco use
during all outpatient clinic visits, the realities of the clinic setting make this difficult
for overworked and overstretched clinical personnel. A computer-based intervention may
enhance patient care by decreasing this burden and priming patients and families for a
discussion about smoking cessation with their physician. Previous research has demonstrated
the feasibility of developing and implementing an interactive computer-based program to
facilitate smoking cessation in the outpatient clinic setting. The program can be
self-administered, presents minimal burden to existing staff, and meets the Public Health
Service practice guidelines. Furthermore, this intervention was found to be effective at
increasing readiness to change in parental smoking behavior. The overall objective of this
proposal is to further develop the program and test this interactive computer-based program
to facilitate motivation and readiness to cease tobacco use and engage in parental smoking
cessation services. The current computer program focuses on the assessment of the
participant's smoking behavior and the delivery of personalized feedback regarding their
smoking behavior. Modifications to the new program will include the removal of the carbon
monoxide testing, inclusion of all baseline and follow-up assessment into the computer-based
program (creating a single, stand-alone package that further reduces staff burden), and the
inclusion of a link directly to the Oklahoma Tobacco Settlement Endowment Trust "click to
call" option (allowing patients to immediately self-refer for cessation support). Parents of
children presenting to a general pediatric outpatient clinic, who self-report as current
smokers, will be recruited for a randomized controlled trial to assess the effectiveness of
the revised computer-based program. It is proposed that exposure to this brief intervention
will result in increasing smokers' readiness to cease tobacco use and engage in smoking
cessation services. The successful completion of the proposed project will result in the
development of a smoking cessation intervention that can be easily and consistently
delivered, in a host of different settings, with little burden to existing staff. The
successful development of such an intervention directly relates to the OTRC Mission and
Goals and specifically fits with two of the OTRC's primary research areas: prevention and
cessation of tobacco use and tobacco-related health disparities in Oklahoma's diverse
populations and reduction of secondhand smoke exposure.

Inclusion Criteria:

1. the parent or caregiver reports active cigarette use

2. the parent or caregiver speaks English as their primary language

Exclusion Criteria:

1. the parent or caregiver is actively attempting smoking cessation

2. the parent or caregiver reads below the 8th grade level

3. the parent or caregiver does not have email or web access