Treating Caregivers Who Smoke at AFCH

All participants will receive a one-time visit with the study physician. This visit will consist of a brief counseling session. Counseling sessions will last approximately 20 minutes and cover the 3 objectives of 1) review participants' motivation for smoking and for quitting; 2) use the information on participants' motives to provide tailored education regarding a) benefits of quitting smoking to the caregiver and the child, b) strategies to reduce nicotine withdrawal symptoms/urges to smoke during the hospitalization, and c) benefits of smoke-free home and car rules; and, 3) review smoking cessation resources.

After the counseling session, participants will be provided a 2-week supply of nicotine patches and nicotine mini-lozenges, along with instructions for their use. The study physician will review how to use the medication, dosing, benefits of use, and potential side effects of use.

Within 24 hours of discharge, participants will be contacted to complete a post-intervention survey, which will assess nicotine replacement therapy (NRT) use during the hospitalization and likelihood that the participant would recommend program implementation in the hospital. Smoking behavior during the child's hospitalization will be examined, including assessments of 1) number of cigarettes smoked per day and 2) number of times participant left the child's bedside to smoke per day. Participant's self-efficacy and interest in quitting smoking will be assessed, using the same questions from the pre-intervention survey, to assess for changes after the intervention.

Participants will be contacted 2 weeks after discharge with a link to complete the follow-up survey to again assess current smoking status, use of NRT post-hospitalization, self-efficacy and interest in quitting smoking, establishment of smoke-free home and car rules, and interest in ongoing smoking cessation treatment.

Inclusion criteria

• Hospitalized child will have a 'yes' response to the screening question, "Does anyone in your household smoke"
• Hospitalized child is expected to be admitted for >24 hours
• Caregiver is at least 18 years of age
• Participant self-identifies as the primary caregiver of the hospitalized child during the hospitalization
• Participant smokes ≥5 cigarettes per day
• Participant is willing and able to use NRT
• Participant is not currently pregnant, trying to get pregnant, or breastfeeding and willing to use acceptable birth control for duration of medication use
• Participant is willing to comply with all study procedures and be available for the duration of the study

Exclusion criteria

• Contraindication to NRT use (pregnancy, myocardial infarction in past 2 weeks)
• Previous reaction to the nicotine patch or mini-lozenge that prevented them from continuing to use it
• Current use of smoking cessation medications (any NRT, bupropion, varenicline)
• Caregiver's child is being cared for by study physician (Dr. Brian Williams)
• Need for an interpreter