title: A smoking cessation intervention for low-income smokers in the ED.
abstract: BACKGROUND
  There is a high prevalence of smoking among caregivers who bring their children to the pediatric emergency department (PED) and even higher rates of tobacco smoke exposure (TSE) and related morbidity among their children. The PED visit presents an opportunity to intervene with caregivers, but it is unknown whether they are more likely to quit if their child has a TSE-related illness. We sought to examine a PED-based smoking cessation intervention and compare outcomes based on children's TSE-related illness.
  
  
  METHODS
  A single-arm, prospective trial, with baseline, 3, and 6 month assessments was used in this study. Caregivers whose child had either a TSE-related (n=100) or non-TSE-related illness (n=100) were given a brief intervention consisting of counseling, referral to the Quitline, and free nicotine replacement therapy.
  
  
  RESULTS
  Participants were 91.5% female, 50.5% African American, 100% Medicaid recipients, 30.8 years old, child age mean of 5.5 years, 90% highly nicotine dependent, and 60.3% and 75.8% allowed smoking in the home and car, respectively. At follow-up (65% retention), 80% reported quit attempts at 3 months and 89% between 3 and 6 months. There were significant decreases in number of cigarettes smoked, time to first cigarette, and smoking in the home and car. Quit rates were 12.2% at 3 months, 14.6% at 6 months, and 7.3% at both time points (50% biochemically confirmed). There were no significant differences in outcomes based on children's illness.
  
  
  CONCLUSIONS
  A brief PED-based smoking cessation intervention resulted in quit attempts and successful quits. However, the presence of a TSE-related illness did not result in different cessation outcomes.
authors.affiliation: Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: melinda.mahabee-gittens@cchmc.org.
authors.forename: E Melinda
authors.initials: EM
authors.lastname: Mahabee-Gittens
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Khoury
authors.affiliation: Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Mona
authors.initials: M
authors.lastname: Ho
authors.affiliation: Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Lara
authors.initials: L
authors.lastname: Stone
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH; Department of Family and Community Medicine, University of Arizona, Tucson, AZ.
authors.forename: Judith S
authors.initials: JS
authors.lastname: Gordon
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003376:Counseling / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid; D010290:Parents; D017060:Patient Satisfaction; D011203:Poverty; D011446:Prospective Studies; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States
chemical_list: D014028:Tobacco Smoke Pollution