Clinical effort against smoke exposure in cystic fibrosis (CEASE-CF): feasibility, acceptability, and preliminary...

Smoke exposure affects one-third of children with CF (CwCF), but smoking cessation strategies for their caregivers have not been tested.

We developed and tested CEASE-CF, a randomized controlled smoking cessation intervention tailored to smoking caregivers of CwCF and delivered by a tobacco treatment specialist (TTS) integrated into the CF care team. The intervention arm received CF-specific smoke exposure education, intake assessment, and treatment (nicotine replacement therapy and 12 counseling sessions over 6 months). The control arm received education. Primary outcomes were feasibility and acceptability among caregivers and providers. Secondary outcomes were 6-month quit rates and child hair nicotine concentrations.

36 caregivers (24 intervention, 12 control) were recruited. Feasibility (64% accrual, 100% retention) and acceptability (86% caregivers satisfied and likely to recommend CEASE-CF, 67% finding it helpful) were high. Providers' (n = 19) mean scores were 4.7 (1-5 scale) for satisfaction, implementation, and recommendation to other clinics. At 6 months, 17% participants had quit smoking, and 78% had a 7-day point prevalence reduction of at least 17%, with an average reduction of 54%. Hair nicotine decreased from 2.7 (SE 0.17) ng/mg at baseline to 1.1 (SE 0.17) ng/mg at 6 months (p < 0.001). At baseline, all hair nicotine specimens were above the exposure threshold of 1.0 ng/mg, but only 41% at 6 months.

Tobacco treatment delivered by a TTS part of the CF care team reduces smoke exposure in CwCF. CEASE-CF is a feasible and acceptable model for smoking cessation that can be incorporated into CF clinical care.