Trial Information

Changing Pediatric Office Systems Nationally to Address Parental Tobacco Use

The CEASE intervention works within existing systems of care to address parental smoking.
Based on national guidelines and extensive qualitative research obtained in pilot testing,
elements of CEASE can be tailored to work with particular practices' staffing, resources,
and physical configuration. CEASE integrates evidence-based tobacco-use screening, cessation
assistance, and referral to outside services into visits with families in pediatric clinics.
Elements include (1) Identification of smokers and self-assessment of quitting preferences;
(2) Counseling (brief motivational messaging elements include collaborative goal setting,
set quit date, personal barriers to quitting, problem-solving strategies, implementing
smoke-free homes and cars, and social support, strategies shown to increase satisfaction
with the pediatric visit.(3) Medication (NRT prescription and free 1 week supply (while
supplies last)—including for those cutting down to quit as recommended in latest
guidelines); (4) Quitline enrollment via faxed enrollment form; and (5) Review of CEASE
action sheets at each visit until the family is smoke-free. We train practices in the
adoption, implementation, and maintenance of the intervention. A more detailed training
manual discusses additional in-depth strategies for maximizing billing and reimbursement,
materials for seasonal cessation opportunities and supporting employees' own cessation
efforts.