Provision of free nicotine replacement therapy to parental smokers in the pediatric emergency setting
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Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States
School of Human Services, University of Cincinnati, Cincinnati, United States
Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States
College of Nursing, University of Arizona, Tucson, United States
E. Melinda Mahabee-Gittens   

Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH, 45229, United States
Publication date: 2020-05-18
Submission date: 2020-02-03
Final revision date: 2020-03-06
Acceptance date: 2020-03-17
Tob. Prev. Cessation 2020;6(May):30
Although the administration of free Nicotine Replacement Therapy (NRT) is effective in helping smokers quit, the feasibility, acceptability and safety of this practice have not been examined in the emergency setting of the pediatric emergency department (PED) or urgent care (UC). We examined the characteristics of parental smokers who were interested and eligible for free NRT during their child’s emergency visit and the uptake, usage, and associated side effects of NRT use.

We analyzed data from 377 parental smokers who were randomized to receive cessation counseling and free NRT as part of an emergency visit-based randomized controlled trial. Parents interested in NRT were screened for medical contraindications; eligible parents were given a 6-week supply of NRT patches or lozenges during their child’s emergency visit and offered another supply 6 weeks later. We conducted Wilcoxon rank-sum tests and chi-squared tests to address our main study objective.

The majority of parents were female (87.5%), non-Hispanic Black (52.5%), and mean (SD) age was 33.1 (8.2) years. A total of 252 (66.8%) parents were interested in receiving NRT. Compared to uninterested parents, interested parents were more likely to: be older [33.6 (8.2) vs 31.9 (8.2), years]; be non-Hispanic Black (54.0% vs 49.6%); have older children [5.5 (5.0) vs 4.2 (4.6)]; have a higher readiness to quit [7.0 (2.4) vs 5.2 (2.6)]; and have a child being evaluated in UC compared to the PED (72.4% vs 56.5%). A total of 53 (21%) interested parents had >1 NRT contraindications. At 6 weeks, 94 (79.0%) parents reported some ≥NRT usage and 50 (53.2%) requested an additional 6-week supply. There were no serious adverse events and 5 (5.3%) reported minor side effects.

Parental smokers in the emergency setting are interested in receiving free NRT, the majority use it, and use is not associated with adverse side effects. The emergency visit may be an optimal time to offer NRT to parental smokers.

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
This research was funded by the National Institutes of Health R01HD083354 (EMMG) and K01DA044313 (ALM).
EMMG conceived the study, overall study aims, study design, and wrote the first draft of the paper. MET and JCK conducted the statistical analyses and interpreted the data. LS supervised participant recruitment and data collection and created databases for analyses. ALM and JSG provided input on the overall study aims, analyses and interpretation of data. All authors made critical comments and revised drafts of the paper. All authors read and approved the final manuscript.
Not commissioned; externally peer reviewed.
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