Summary of Grants

Parents Actively Controlling Tobacco (PACT)

A substantial proportion of children obtain their first cigarettes from family members without the adult’s knowledge.  Our research has shown that among adolescent smokers, nearly 31% had stolen cigarettes from a family member, with 13.2% stealing from their mother, 7.7% stealing from their father, and 11.5% stealing from their siblings (Robinson, Dalton, & Nicholson, 2006).  These findings extend the work of other authors, who also found that adolescents frequently report getting their first cigarettes at home (DiFranza & Coleman, 2001).

Despite this research, no previous study has developed and evaluated a program designed to encourage parents to control their tobacco products.  A logical point of intervention lies in physicians’ practices, because 90% of children see a health care professional each year (Centers for Disease Control and Prevention, 2012).  Research has shown that physician- administered interventions are effective at reducing tobacco use directly among adolescents (Hum, Robinson, Jackson, & Ali, 2011; Shelley et al., 2000), reducing environmental tobacco smoke (ETS) exposure among children (Hovell, Zakarian, Wahlgren, & Matt, 2000), and reducing parental smoking (Winickoff, 2005).  Notably, even parents who smoke support pediatricians’ efforts to reduce smoking among children, and adult smokers are more amenable to discussions regarding smoking than physicians believe they are (Moss, Cluss, Mesiano, & Kip, 2006).

Thus, this study was designed to:

(1) Develop, implement, and evaluate a program to train physicians to interact with parents who smoked about tobacco control using a motivational interviewing framework.

(2) Examine whether pediatricians’ knowledge about smoking, attitudes towards smoking, and other outcomes changed from baseline (prior to training program) to follow-up.

(3) Examine the efficacy of the physician intervention on parent outcomes by examining potential changes in the parents’ knowledge about teen smoking, attitudes toward it, and tobacco control behaviors.

Current status:

Data collection for this project is completed.  We are currently analyzing the data, and the initial analyses have been presented to the TN American Academy of Pediatrics.  Briefly, we found that parents significantly increased their tobacco control behaviors after the intervention.  In addition, parents tightened tobacco control for adults in their homes, and overall, children’s exposure to second-hand smoke was reduced.  We are currently in the process of writing up these results for conferences and manuscript.

OTHER DATASETS AVAILABLE

Our lab has a number of large datasets available that were created through grant funding.  Each of these is briefly described below.  Manuscripts are being produced from each of these unique datasets.

Project PACT: Parents Actively Controlling Tobacco (PACT): Teens often obtain their first cigarettes in their homes, using packs unattended by parents who smoke. The purpose of this study was to train pediatricians to help parents make it more difficult for their offspring to get their cigarettes. Toward this end, we taught pediatricians motivational interviewing methods for communicating with the parents of their young patients. Funded at $20,000 by the TN Chapter of the American Academy of Pediatrics, this was the first study to use pediatricians to address this important issue.

The Adolescent Smoking Cessation and Evaluation Study (ACES): Despite prevention efforts, 1/3rd of high school students in this country are smokers by the time they graduate. Most of them make multiple attempts to quit while still in school, but the odds of their success are extremely low. Unfortunately, most cessation programs to date have not proven successful with teens. With nearly $1 million in funding from the National Institute of Drug Abuse, the ACES project gathered data from young smokers about the barriers that interfere with their attempts to quit and the cessation strategies that are most appealing to this population. We are currently in the process of data analysis.

The Memphis Health Project (MHP) was a multi-million dollar project funded by the National Institutes of Health in 1993. The purpose of this large-scale grant was to identify the variables that prompt adolescents of different genders and ethnicities to smoke. Unlike most previous projects of this kind, we were able to obtain continuous funding from NIH for a decade, with annual data from a cohort of 7,000 students. First surveyed when they were in 7th grade, these youth were followed until they were young adults. The MHP has yielded multiple publications and presentations, and it is now recognized as a major contributor to our understanding of smoking onset in minority youth.

The Memphis Smoking Prevention Project (MSPP): MSPP was an innovative smoking prevention program funded by the Partnership for Women's and Children's Health. It was specifically tailored to serve the biethnic population served by the Memphis City School System. Middle schools were randomized to receive the special curriculum or to continue current programming. The curriculum was first offered in 7th grade, and for students in treatment schools, boosters were offered in 8th, 9th, and 10th grades. Thus, students in the treatment condition received tailored prevention programs for four years. Results of this trial indicated that changes occurred in a predictable fashion, with treated students obtaining more information about smoking in the 7th grade, developing more negative attitudes toward smoking in the 8th grade, and during the 9th grade, showing significantly less use to tobacco. The database is extensive and complex and continued analysis is still possible.