This planning project was designed to improve pediatricians’ ability to intervene with the parents who smoke in their patient population.  A chart sticker system was implemented to identify the parents that smoke.  An interactive CD-ROM training program was developed and distributed to participating pediatricians.  A reimbursement plan was also created by the HMO to provide a monetary incentive to pediatricians who provide cessation counseling to parents. 

Baseline data showed that many pediatricians asked and advised parents on tobacco cessation; however, they rarely provide assistance and arrange cessation services.  The follow-up survey revealed an increase in the amount of assistance provided for smoking cessation.  Low rates (58% of pediatricians completed the baseline survey, 37% completed the follow-up survey, and 47% completed the CD-ROM training) may be due to the timing of the study (during a high seasonal illness period) and computer compatibility issues. 

Although the project resulted in low numbers of pediatricians who completed the training and sought reimbursement for cessation counseling, those who completed the training reported improvements in their knowledge and confidence to provide cessation counseling.  The CD-ROM training program also was utilized in the residency training clinic which may impact the tobacco cessation counseling of future pediatricians.