{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:57:02Z","timestamp":1784746622581,"version":"3.55.0"},"reference-count":37,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"\n \n <\/jats:sec>\n \n BACKGROUND<\/jats:title>\n Parental smoking is a leading source of secondhand smoke exposure for children, increasing risks of respiratory illness and future smoking. Cessation treatment delivery for parents remains rare in pediatrics. This study evaluates the population-level impact of an automated tobacco treatment system integrated into the electronic health record (EHR) in pediatric primary care.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n We conducted a retrospective observational study of parents whose children received care at 12 pediatric practices in a cluster-randomized trial (June 2021-August 2024). Six practices implemented an automated EHR-linked parent tobacco treatment system (screening, motivational messaging, automatic treatment connection including nicotine replacement therapy, SmokefreeTXT, and quitline referral through a previsit questionnaire); 6 implemented screening only. This analysis included all parents who completed questionnaires during routine care, excluding parents enrolled in the trial. We analyzed self-reported cessation rates among parents who reported smoking during the study period.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Among 55\u2009567 parents with follow-up data (49\u2009595 mothers; 5972 fathers), smoking rates were 4.3% vs 5.5% for mothers and 6.5% vs 8.3% for fathers receiving care with vs without the system. Among mothers who reported smoking during the study, cessation rates were significantly higher for those receiving care with the system (37.4% vs 33.5%, P\u2009=\u2009.044), representing a 3.9% improvement. Among fathers who smoked, there was no difference in cessation rates (29.6% vs 29.6%).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n An automated tobacco treatment system was associated with significantly increased maternal smoking cessation in pediatric settings while showing no effect for fathers. This scalable approach could enhance pediatric preventive care by reducing household tobacco use.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2025-073934","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:02:26Z","timestamp":1773705746000},"source":"Crossref","is-referenced-by-count":2,"title":["An Electronic Health Record\u2013Based Tobacco Treatment System for Parents in Pediatric Primary Care"],"prefix":"10.1542","volume":"157","author":[{"given":"Brian P.","family":"Jenssen","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"2Clinical Futures, PolicyLab, and The Possibilities Project, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"3Department of Biomedical and Health Informatics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abra M.","family":"Jeffers","sequence":"additional","affiliation":[{"name":"4Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts"},{"name":"5Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"6Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emara","family":"Nabi-Burza","sequence":"additional","affiliation":[{"name":"4Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts"},{"name":"5Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janani","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"2Clinical Futures, PolicyLab, and The Possibilities Project, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeritt","family":"Thayer","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"2Clinical Futures, PolicyLab, and The Possibilities Project, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"3Department of Biomedical and Health Informatics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany Hipple","family":"Walters","sequence":"additional","affiliation":[{"name":"4Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts"},{"name":"5Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas E.","family":"Levy","sequence":"additional","affiliation":[{"name":"5Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"6Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"7Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"W. Grundmeier","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"3Department of Biomedical and Health Informatics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Drouin","sequence":"additional","affiliation":[{"name":"8Division of General Pediatrics, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montr\u00e9al, Quebec, Canada"},{"name":"9Department of Pediatrics, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada"},{"name":"10Department of Social and Preventive Medicine, School of Public Health, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Vangel","sequence":"additional","affiliation":[{"name":"11Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Rigotti","sequence":"additional","affiliation":[{"name":"5Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"6Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"7Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyra","family":"Bryant-Stephens","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Fiks","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"2Clinical Futures, PolicyLab, and The Possibilities Project, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"3Department of Biomedical and Health Informatics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Winickoff","sequence":"additional","affiliation":[{"name":"4Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts"},{"name":"5Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts"},{"name":"7Harvard Medical School, Boston, Massachusetts"},{"name":"12American Academy of Pediatrics, Julius B. 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