Smoking cessation program for CF caregivers shows benefits: Study
CEASE-CF helps them feel more confident about quitting, reduce cigarette use
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A smoking cessation program designed specifically for families of children with cystic fibrosis (CF) helped caregivers better understand the harms of smoke exposure, feel more confident about quitting, and reduce their cigarette use, according to a new study.
The initiative, called Clinical Effort Against Smoke Exposure in Cystic Fibrosis (CEASE-CF), is delivered by a trained tobacco treatment specialist (TTS) integrated into the CF care team. Interviews with caregivers and healthcare providers suggest the approach was not only effective but also feasible within routine CF clinic visits.
“CEASE‐CF positively impacted caregivers by increasing their awareness of the sources and harms of smoke exposure, equipping them with tools to change habits, and enhancing their self‐reported confidence and self‐efficacy for quitting,” researchers wrote. “Consistent and multifaceted cessation support provided by a trained TTS is practice‐changing and can be successfully integrated in CF care delivery.”
The study, “It Was All Tailored Around Me”: Qualitative Evaluation of Clinical Effort Against Smoke Exposure in Cystic Fibrosis (CEASE-CF),” was published in the journal of Pediatric Pulmonology.
About a third of US children with CF exposed to tobacco smoke reguarly
For children with CF, a genetic condition marked by a progressive decline in lung function, tobacco smoke exposure can be especially harmful. Exposure includes not only secondhand smoke — inhaling smoke from someone else’s cigarette — but also thirdhand smoke, the toxic residues that linger in the air and on clothing and other surfaces.
Yet, about one-third of U.S. children with CF are regularly exposed to tobacco smoke. Despite guidelines recommending screening for tobacco smoke exposure during pediatric visits, implementation is inconsistent, and smoking cessation programs for CF caregivers have not been tested.
The CEASE-CF initiative was developed to address this gap. Its feasibility and effectiveness in reducing smoke exposure among children with CF have been assessed in a single-center U.S. study (NCT04777344) involving 36 caregivers. In that study, 24 participants received the intervention from a TTS using a nonjudgmental, person-centered approach. The program combined CF-specific education about smoke exposure harms, assessment of readiness and barriers to quit, nicotine replacement therapy, and up to 12 behavioral counseling sessions over six months. The remaining 12 caregivers received educational materials only.
In this study, researchers present qualitative findings from in-depth interviews with 12 caregivers who participated in the intervention, along with 10 CF healthcare providers, to better understand their experiences and the practical aspects of implementing the program in routine CF care.
Caregivers had a mean age of 39.1 and were mostly women (75%). Most were parents (58.3%) or grandparents (41.7%). Clinical providers included five pulmonologists, two nurses, two dietitians, and one social worker.
‘It did seem that it was all tailored around me’
Many caregivers said the program increased their knowledge of how smoke exposure could directly harm their child with CF, especially thirdhand smoke. Some admitted they had believed smoking outside was enough to protect their child.
“I smoke outside, but the [thirdhand] smoke was a whole other thing that people really don’t think about,” one caregiver said. Another added, “I didn’t know just how bad it was.”
Such awareness became a powerful motivator. As one participant said, “I’m just gonna have to go ahead on and put them [cigarettes] down ‘cause I don’t want anything that gonna harm my babies.”
Caregivers also described a noticeable shift in their confidence about quitting. Many entered the program believing they would never be able to stop smoking. Over time, that mindset changed.
“It built up self-confidence because you didn’t feel alone,” one caregiver said. Another explained, “I always thought, […] ‘Oh, shoot, I’ve started a bad habit, and I’m never gonna be able to quit,’ but it definitely helps you realize that, ‘Yeah, you can quit, it’s never too late.’”
Even those who did not quit entirely often reduced their cigarette use substantially. One caregiver shared, “I’ve slowed down. I smoke about […] a pack and a half less.”
By simultaneously addressing knowledge gaps, behavioral challenges, psychological barriers, and system constraints, the program offers a comprehensive solution to a persistent problem in CF disease management.
The TTS was widely praised. Caregivers valued the personalized, nonjudgmental support and practical guidance on nicotine replacement therapies and coping strategies. Many highlighted the emotional support they received, particularly during stressful moments.
“She was not judgmental at all. I mean, she just understands, people smoke,” one caregiver said. Another described the experience as highly individualized: “It did seem that it was all tailored around me.”
Regular follow-up calls were especially meaningful. Caregivers said the check-ins created accountability and helped them stay focused and motivated.
“I think it was just her calling and encouraging and motivating me,” a participant said. “I paid more attention to how many I was smoking because I knew I would be talking to her in a week,” another added.
Healthcare providers also viewed the program positively. They said the TTS became a true member of the multidisciplinary CF team and that the intervention did not significantly disrupt clinic workflow.
“By simultaneously addressing knowledge gaps, behavioral challenges, psychological barriers, and system constraints, the program offers a comprehensive solution to a persistent problem in CF disease management,” the researchers concluded.
