New Investigator Grants
Julius B. Richmond New Investigator Grants are designed to stimulate involvement of pediatricians and other child health researchers nationwide in innovative research to protect children and eliminate exposure to secondhand smoke. Grants of up to $12,000 are awarded on a competitive basis to support research projects addressing children's secondhand tobacco smoke elimination or reduction.
The call for 2020 New Investigator Grant Applications is closed. Future application cycle information will be posted as it becomes available.
Secondhand Smoke Exposure and Therapeutic Efficacy in Cystic Fibrosis
Benjamin Wisniewski, MD, Division of Pulmonary Medicine, Nationwide Children’s Hospital
The long-term goal of this study is to identify therapeutic and preventive interventions that mitigate secondhand smoke exposure (SHSe) in cystic fibrosis (CF) patients and other susceptible populations. Using acute and chronic models of combustible cigarette and e-cigarette SHSe, the study’s preliminary data suggests SHSe suppress function of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. An improved understanding of how SHSe alters immune function and the therapeutic efficacy of CFTR modulators in children with CF is needed to inform clinical prevention efforts, identify biomarkers of SHSe, and develop novel pathway-targeted therapeutics that alter disease severity. The specific aims of the study will test SHSe from combustible tobacco cigarettes on patients with CF, and will compare the effects of SHSe from combustible tobacco cigarettes and e-cigarettes on CFTR modulator efficacy.
Smoke Exposure Disclosure: Parent Perspectives of Screening
Brian Williams, MD, FAAP, University of Wisconsin School of Medicine and Public Health, and American Family Children’s Hospital
This study will identify factors that influence parent disclosure of tobacco smoke exposure (second or thirdhand) when screened during their child’s hospitalization. The approach will be to conduct qualitative interviews, using specific screening questions that have been reviewed in prior studies. The study aims to identify caregiver perspectives of factors (barriers and facilitators) that influence successful screening for tobacco smoke exposure of children in the inpatient setting. It also aims to identify caregiver perspectives on strategies to most effectively screen for smoke. The long-term goal of this research is to improve the sensitivity of tobacco screening in order to identify and intervene with smokers and decrease pediatric tobacco smoke exposure.
Reducing Socioeconomic Disparities in Smoke-Free Rules among Households with Children
Michael J. Parks, PhD, Minnesota Department of Health
Annually, 1 in 5 deaths in the United States are related to cigarette use and secondhand smoke (SHS). Voluntary household smoke-free rules can mitigate tobacco-related morbidity and mortality, principally by reducing SHS exposure and tobacco use. Critical disparities related to socioeconomic status (SES) persist in terms of household smoke-free rules, contributing to disparities in tobacco-related illnesses. This study will examine an evidence-based intervention for promoting smoke-free homes among socioeconomically disadvantaged smokers and nonsmokers who live with a smoker. The primary aim of the study is to address disparities in SHS exposure among children by reducing disparities in smoke-free rules in homes and cars among low socioeconomic smokers and nonsmokers who live with a smoker.
Behavioral Economics of Parental Tobacco Control
Olivier Drouin MDCM, MSc, FAAP; Massachusetts General Hospital, Boston, MA
A vast majority of parents know that smoking is harmful to both their health and the health of their child, and a majority of adults who smoke want to quit. Despite this, 17% of children live in a home where someone smokes inside and over one-third of smokers do not attempt to quit. Behavioral economics is a growing field of inquiry that uses empirical studies to explain apparently “irrational” behaviors, such as the gap between declared intentions and observed behaviors. This study will evaluate the influence of two constructs from behavioral economics on parental smoking: the perceived risk of smoking to their child’s health, and the perceived prevalence of parental smoking in their environment and local community. The hypothesis is that parents who smoke will overestimate the prevalence of parental smoking in their community and, among parents who smoke, those with a larger discrepancy between their perceived prevalence and that reported for their community, will be less likely to link to smoking cessation services and will be less likely to quit.
Pediatrician Message Framing to Protect Children from Secondhand Smoke Exposure
Brian P. Jenssen, MD, MSHP, FAAP; The Children’s Hospital of Philadelphia, Philadelphia, PA
Pediatricians are uniquely positioned to protect children from secondhand smoke (SHS) exposure by educating, motivating, and initiating tobacco dependence treatment for parents who smoke. While interventions to achieve smoking cessation among parents can help protect vulnerable children from SHS, improved design and implementation of these interventions are needed to increase their effectiveness. To achieve this goal, there is a critical need for a better understanding of effective pediatrician-parent communication, specifically how best to leverage parents’ concern for their child’s health to most strongly impact their intention to protect their children from SHS exposure by quitting smoking. This study will quantitatively assess, through a discrete choice experiment, the relative importance of a range of messages on parent smoker intention to reduce their child’s SHS exposure and engage in tobacco dependence treatment. This study aims to develop an evidence-based message framing approach to promote parental smoking cessation in the pediatric setting and to identify patient and parent factors associated with different patterns of responsiveness to different message frames.
Secondhand Smoke Exposure Influences on Growth, Lung Function, and Inflammation in Young Children with Cystic Fibrosis
Benjamin Kopp, MD, FAAP; Nationwide Children’s Hospital, Columbus, OH
Newborns diagnosed with cystic fibrosis (CF) have a critical window of time in the first three years of life where intervention can affect long-term pulmonary outcomes. Adequate nutrition in CF is directly linked to lung function and patient outcomes, but the impact of secondhand smoke (SHS) on growth, inflammation, and lung disease in CF is unclear. While SHS is linked to micronutrient deficiencies in healthy children, this has not been examined in CF. This study will explore the effects of SHS on growth and structural/functional/inflammatory lung disease in CF in the newborn screening clinic. The hypothesis is that SHS exposure in young patients with CF will retard growth and influence inflammatory signaling leading to increased respiratory dysfunction.
Efficacy of an Online Course on Training Pediatricians to Help Parents Quit Smoking
Jyothi Marbin, MD, CTTS, FAAP; University of California San Francisco, Oakland, CA
The purpose of the Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention is to improve clinicians’ abilities to screen pediatric patients for secondhand smoke (SHS) exposure, and, for family members who smoke, provide brief behavioral counseling, prescribe nicotine replacement therapy and refer to the smoker’s cessation helpline. While CEASE has been shown to increase meaningful assistance to parents who smoke, dissemination has been challenging given the high costs associated with in-person trainings due to the costs of travel, staff time, etc. This study will translate the evidence-based CEASE intervention into an online training course using principles of instructional design. It will then gather preliminary data on the efficacy of the online training compared to the in-person training.
Secondhand Smoke in Children with Sickle Cell Disease
S. Christy Sadreameli, MD, FAAP; Johns Hopkins University, Baltimore, MD
This study seeks to evaluate the impact secondhand smoke (SHS) exposure has on asthma diagnosis, respiratory symptoms, and pulmonary function in children with Sickle Cell Disease (SCD), in whom both asthma and pulmonary function abnormalities are common. The hypothesis is that children with SCD who are exposed to SHS are more likely to have an asthma diagnosis and lower airway obstruction on pulmonary function tests compared to age and SCD genotype-matched controls who are not exposed to SHS; 2) The study also seeks to evaluate atopy as a potential influence or confounder of the relationships between SHS, asthma/pulmonary function, and increased sickle cell morbidity. The study hopes to prove that SHS causes increased disease complications in SCD through direct, harmful effects on the lungs.
A Comparison of Parents/Caregivers of Healthy vs. Sick Neonates: Is There a Difference in Readiness and/or Success in Quitting Smoking?
Rachel Boykan, MD, FAAP; Stony Brook Long Island Children's Hospital, Stony Brook, NY
This study will compare parents of sick neonates with those of healthy newborns, and hopes to further identify whether the illness of a child (and other associated factors) contributes to parents' quitting success. Specifically, this study will identify factors associated with readiness to quit smoking among parents/caregivers of sick neonates. Success (quit rate) of the referral system will be tracked to the New York state quitline with the implementation of a computerized referral system offered to all smoking parents/caregivers of neonates and determine whether quit rates differ by child health status. Factors associated with quit rates among parents/caregivers of healthy vs. sick neonates will also be identified.
Decreasing Childhood Environmental Tobacco Smoke Exposure by Improving Knowledge in Parents and Caretakers of Children Hospitalized for Respiratory Illnesses
Susan Walley, MD, FAAP; University of Alabama at Birmingham, Division of Pediatric Hospital Medicine, Birmingham, AL
This study will expand on the original pilot study based on the educational video "Smoking and Kids Don't Mix" geared towards parents and other caretakers of children with environmental tobacco smoke (ETS) exposure, which was developed in partnership with the Children's of Alabama Comprehensive Health Education Center for Kids (CHECK). This seven minute video reviews the adverse health effects of ETS on children and provides strategies to reduce childhood ETS exposure, including smoking cessation. Further research is needed to confirm the pilot study's findings in a larger group, to ascertain if there is a long-term gain in knowledge of the adverse effects of ETS exposure in children, and determine if there is any subsequent behavior change associated with improved knowledge. This study has two phases: baseline and follow-up. The primary outcome will be improved knowledge of the adverse efffects of childhood ETS exposure at one and three months in comparison to pre-video knowledge. Secondary outcomes will be improved stage of change for smoking cessation and behavior changes including self-reported calls and referrals to the Alabama State quitline, enacting a home or vehicle smoking ban, or smoking reduction or cessation.
Implementation and Evaluation of a Pilot Secondhand Smoke Awareness/Tobacco Cessation Program in a Large Urban Primary Care Center Asthma Medical Home
Faye Holder-Niles, MD, MPH, FAAP; Children's Hospital Primary Care Center, Boston, MA
This project will pilot a secondhand smoke awareness/ tobacco cessation intervention for families of asthmatic patients receiving care at Children's Hospital Primary Care Center. This study proposes that increased identification of a patient's secondhand smoke exposure, assessing parental readiness to quit, and delivering targeted counseling interventions through an asthma medical home framework will facilitate increased opportunities to positively impact the health of pediatric asthma patients.
Is Child Hospitalization a Teachable Moment for Parents Who Smoke?
Shawn Ralston, MD, FAAP; University of Texas Health Science Center San Antonio, San Antonio, TX
The goal of this study is to change pediatricians' approach to parents who smoke by providing a much-needed service at an opportune moment. Smoking caregivers of hospitalized children will be recruited and randomized to the intervention or control group; the intervention group will include brief smoking cessation counseling and referral to the state's Quitline.
Investigating the Link Between Secondhand Tobacco Smoke and Inflammation in Children with Asthma
Emily Weis, MD; University of Rochester School of Medicine and Dentistry, Rochester, NY
The goal of this study is to determine the association between asthma and markers of inflammation in both blood and nasal secretions of two-year-old children exposed to secondhand smoke. Parents of 45 children will be interviewed, chart reviews will be conducted, and saliva samples will be taken from children to determine their exposure to secondhand tobacco smoke.
Investigating the Link Between Secondhand Smoke and Inflammation in Children:
Karen M. Wilson, MD, MPH, FAAP; University of Rochester, Rochester, NY
The study aims to determine the association between secondhand smoke exposure and serum markers of inflammation in hospitalized children by comparing serum levels of inflammatory markers in healthy smoke-exposed and non-smoke-exposed children who are scheduled to have a routine ear, nose, and throat procedure.
Prevention of Postpartum Smoking Relapse in Mothers of Preterm Infants in the Neonatal Intensive Care Unit
Raylene M. Phillips, MD, FAAP; Loma Linda University, Loma Linda, CA
The goal of this study is to prevent postpartum smoking relapse during the first eight weeks after the birth of a preterm infant in mothers who quit smoking just prior to or during their pregnancy. Maternal knowledge about preterm infants' behavioral cues, levels of maternal stress and depression, and duration of breastfeeding will also be evaluated.
Using Pediatric ED Visits as "Teachable Moments" for Maternal Smoking Cessation
Melanie Prusakowski, MD, FAAP; Children's Hospital of Philadelphia, Philadelphia, PA
Two brief motivational interventions will target smoking mothers of children less than six years who present to Emergency Departments with high and low motivation to quit. Interventions will be piloted with a follow-up phone call and resource card; a control group will receive general advice and a resource card. The primary outcome is change in self-reported number of cigarettes smoked daily at one month.
The Effect of Using a Structured Tobacco Cessation Education Program in Resident Training on Reducing Secondhand Smoke Exposure in Young Children
Roopa Shankar, MD; SUNY Upstate Medical University, Syracuse, NY
This randomized controlled trial evaluated the effectiveness of a structured tobacco cessation education program (NY-CEASE), delivered by pediatric residents in the outpatient continuity clinic of a pediatric residency program in reducing the exposure of infants to secondhand smoke, and the efficacy of using cotinine measurement and feedback as an adjunct to counseling versus usual care.