Automated intervention shows significant increase in smoking cessation behavior

Researchers at Children’s Hospital of Philadelphia (CHOP) found that a new automated tobacco treatment system integrated into routine pediatric care helped drive a 3.9% absolute increase in smoking cessation among mothers—a population-level impact that could translate to tens of thousands of parents quitting each year and protect hundreds of thousands of children from harmful secondhand smoke exposure.

The study, published in Pediatrics, demonstrates how technology can scale preventive interventions without adding burden to clinical staff.

More than 40% of children in the U.S. are exposed to secondhand smoke, increasing their risk of respiratory infections, asthma flare-ups and premature death. Parents who quit smoking not only increase their own life expectancy but also decrease the likelihood of their children becoming smokers later in life.

While some parents who smoke may not have their own primary care health physician, they will seek primary care for their children multiple times a year. Researchers have been working to implement the Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention to address parental smoking by providing routine access to cessation resources during pediatric primary care visits.

“We’ve created a system that removes the traditional barriers, such as provider time, prescribing challenges, and workflow burden,” said lead study author Brian Jenssen, MD, MSHP, Assistant Professor of Pediatrics at the University of Pennsylvania Perelman School of Medicine and a pediatrician at CHOP.

“By automating the screening, motivation, and connection to evidence-based treatment, we’re reaching parents at scale during a moment when they’re already focused on their child’s health.”

“Millions of parents who smoke attend pediatric visits annually, so even a small but noticeable decrease in smoking cessation can translate to tens of thousands of additional individuals who quit each year, which protects hundreds of thousands of children from secondhand smoke exposure,” said co-senior study author Alexander Fiks, MD, a pediatrician and the Director of Clinical Futures and the Possibilities Project: Innovation in Pediatric Primary Care at CHOP.

Building upon findings from a prior study, researchers conducted a retrospective study of parents whose children received care across 12 pediatric practices in a cluster-randomized trial between June 2021 and August 2024.

An automated EHR-linked parent tobacco treatment system was implemented at six practices, while the other six only implemented screenings with no follow-up. This study analyzed self-reported smoking cessation rates among parents who reported smoking during the study period.

This analysis included all parents who completed questionnaires during routine care, excluding parents enrolled in the trial. The team analyzed self-reported cessation rates among parents who reported smoking during the study period.

With data from more than 55,000 parents analyzed, the study found that cessation rates were 3.9% higher for those receiving care with the system compared with those who did not receive the prompts and connections to evidence-based treatments. This increase in cessation behavior was only observed in mothers who participated.

Among fathers who smoked, there was no difference in smoking cessation rates. Overall, the system required no additional training for clinical staff and was implemented within existing EHR workflows, making it readily scalable to other pediatric health systems.