A Brief Smoking Intervention on Caregivers to Reduce Tobacco Smoking Exposure in Asthmatic Children: Evaluating its Effectiveness and Exploring Barriers to Successful Smoking Cessation

Introduction: Parental smoking exposure is proven to be a significant modifiable factor in pediatric asthma exacerbations. Institutions worldwide have worked on reducing tobacco smoke exposure by counselling caregiver smokers. However, the existing brief smoking cessation program at KK Women’s and Children’s Hospital, has yielded a low take-up rate for intensive smoking cessation program and 6-month quit rate.

Objective: This study aims to evaluate the effectiveness of a modified brief smoking cessation program and explore barriers to successful smoking cessation.

Methods: Our study adopts a mixed method approach. Caregiver smokers were invited to go through the modified brief counselling followed by an optional intensive smoking cessation. Survey forms were given, at four specific time points – before and after the brief counselling, at 3 months and at 6 months. Variables such as quit rates, knowledge on smoking, motivation to quit, nicotine dependence and asthma control of child, were assessed using relevant validated questionnaires.

Secondly, one-on-one in-depth interviews were conducted with healthcare providers and caregiver smokers, to evaluate their attitudes and perspectives on parental, until saturation is reached. Thematic coding was utilized to present the themes elicited.

Results: 81 met the inclusion criteria and were enrolled in the quantitative component of study. 28 declined and 53 were recruited in the study. 1 subject withdrew and 52 are currently under follow-up.

Preliminary analysis shows that there is statistical significant difference in take-up rate for intensive smoking cessation program at 15.1%, as compared to previous method, at 4.58% (p<0.05).

For the qualitative component, 16 participants were recruited in the study. Thematic coding is underway.

Conclusion: Preliminary data from this pilot prospective study suggests that the modified brief smoking cessation counselling may increase the smokers’ motivation to quit. However, longer follow-up is required to determine if there is an increase in quit rate and its impact on pediatric asthma.

(Follow-up data up to 3-month and completed qualitative analysis will be ready by October 2017.)