Work

Refer2Quit: A pilot referral approach to promote treatment for parents who smoke tobacco through pediatric primary care

Year: 2025

Type: article

Abstract: Evidence-based tobacco treatments are rarely provided to household members who smoke but do not attend a child’s pediatric visit. This pilot study evaluated an electronic health record (EHR)-linked intervention leveraging pediatric visits to identify and engage household members who smoke tobacco in treatment remotely. We conducted a single-arm prospective study with household members who smoke at a high-volume pediatric primary care practice. During preventive visits, the EHR system screened parents for tobacco use, automated treatment connections, and prompted referrals for household members who smoke. Referred household members were contacted, consented, and offered nicotine replacement therapy (NRT), quitline counseling, and/or SmokefreeTXT. Outcomes included feasibility (referral rate), effectiveness (treatment acceptance), and acceptability (satisfaction). A 1-month follow-up survey assessed treatment use and smoking cessation (7-day abstinence from combustible tobacco). Between April 2022 and August 2024, 3478 pediatric patients had additional household members who smoke. Of 352 (10.1 %) referred individuals, 350 were contacted; 91 (25.9 %) accepted treatment. Among these, 82 (90 %) chose NRT, 58 (64 %) chose quitline, and 64 (70 %) chose SmokefreeTXT. All participants found the referral approach acceptable. At follow-up, 54 (59 %) completed the survey; 42 (46 %) reported treatment use, and 12 (13 %) reported smoking cessation. This EHR-linked intervention effectively identifies and engages household members who use tobacco in treatment, demonstrating feasibility, acceptability, and promising outcomes. These findings warrant more rigorous evaluation. • A key barrier to reducing SHS exposure in children is finding a scalable way to engage all household members who smoke. • We developed an EHR-linked system that screens parents, automates treatment, and prompts referral of household members who smoke. • A pilot using population health and informatics to engage household members who smoke in treatment was feasible, acceptable, and effective. • This approach may expand tobacco treatment reach, reduce SHS exposure, support whole households, and enhance public health impact.

Source: Drug and Alcohol Dependence Reports

DOI: 10.1016/j.dadr.2025.100322