P2B373: Assessment of the Smoke Free Families Tobacco Screening, Counseling, and Referral Program in Pediatric Primary Care Practices

Purpose/Objectives: The Smoke Free Families (SFF) program trained pediatric providers to use a SFF tool during well-child visits (WCVs) of infants ≤ 1 year old to “Ask” caregivers about tobacco use, “Advise” smokers to quit, and “Refer” smokers to cessation services (AAR). The study objective was to assess AAR rates, prevalence of caregiver tobacco use at an initial visit, and changes in caregiver tobacco use at a subsequent WCV.

Design/Methods: Pediatric practices participated in one of three 6–9-month SFF program sessions. Over the three waves of data collection, all initial SFF tools completed on caregivers during their infant’s WCV were evaluated for caregiver and household member tobacco use and providers’ AAR rates. An infant’s first and next WCV were matched to determine changes in caregiver tobacco product use patterns.

Results: Over all 3 waves, the SFF tool was completed at 19,976 WCVs; 2081 (18.8%) infants were exposed to tobacco smoke by caregiver or another household member. Type of tobacco product they used. 884 (90.9%) smoked combustible tobacco products (e.g., cigarettes, cigars) only, 43 (4.4%) dual-used combustible tobacco products and electronic cigarettes, and 45 (4.6%) solely vaped electronic cigarette products..A total of 834 (74.1%) caregivers who smoked received counseling: 786 (69.9%) were advised to quit, 700 (62.2%) were given cessation resources, and 198 (17.6%) were referred to the Ohio Quitline. 230 (29.3%) of smoking caregivers were counseled to quit and had a second visit. Among this group, 58 (25.2%) self-reported that they quit using tobacco. 183 (23.3%) tobacco users that were counseled had tobacco product usage numbers at both initial visit and second visit. For those reporting specific tobacco product usage 89 (48.6%) reported that they used fewer cigarettes at follow-up.

Conclusion/Discussion: Pediatric providers successfully incorporated an AAR tool into infants’ WCVs which resulted in caregiver behavior change. Systematic use of this tool could improve the health of caregivers and children, resulting in decreases in tobacco-related morbidity.