Kids safe and smokefree: an ongoing multilevel intervention trial addressing underserved children’s tobacco smoke exposure

Abstract

Introduction: Addressing child secondhand tobacco smoke (SHS) exposure is a public health priority (WHO). Our trial tests a multilevel intervention linking brief pediatric provider advice with individualized telebased counseling for parents focused on SHSe protections and smoking cessation. Methods: We modified pediatrics systems’ electronic assessments and trained providers throughout Philadelphia, PA, USA to educate smoking parents about SHS harms and the health benefits of protecting children from SHS. These providers referred parents to the trial. Parents are randomized to either 12 weeks of telebased smoking counseling or an attention control condition focused on nutrition education. Results: We have received >2900 referrals, enrolling over 300 parents (~90% retention). Over 80% of participants are women and African American, and over 75% are below the poverty line. Results suggest that relative to controls, the multilevel group: a) was less likely to smoke around their child, and b) was more likely to implement residential smoking bans (p<.05). Discussion: Adding telephone counseling significantly improved the low-intensity pediatric clinic intervention, suggesting that multilevel interventions are sustainable models that hold great promise for reducing child SHS exposure.