Children's Health

Hospitalization of children for respiratory illness presents an opportunity to counsel their parents about smoking

Children who are exposed to environmental tobacco smoke (ETS), usually through parental smoking, are at greater risk than other children for asthma and respiratory infections. When the children of parents who smoke are hospitalized for respiratory illness, it is an opportunity to counsel the parents about quitting smoking.

In a recent study supported by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00063), Jonathan P. Winickoff, M.D., M.P.H., of Massachusetts General Hospital, and his colleagues offered the Stop Tobacco Outreach Program to 71 parents who smoked and whose children were hospitalized in the facility for asthma, pneumonia, or other respiratory illness. The program includes an initial 20 minute face-to-face motivational interview and two followup telephone calls for counseling 5 and 10 days later, written materials, nicotine replacement therapy (NRT, gum or patch), and a note faxed to the parent's primary care provider to schedule an appointment to discuss their smoking.

Overall, 80 percent of parents completed all counseling sessions, and 56 percent accepted free NRT at the time of study enrollment. At the 2-month followup, 49 percent of parents had a stop-smoking attempt that lasted at least 24 hours, 21 percent had not smoked a cigarette in the last 7 days (more than the quit rate of U.S. smokers of 2 to 3 percent per year), 27 percent had used NRT, and 38 percent had visited their primary care doctor to discuss quitting smoking. Also, far more parents said they prohibited smoking in the house after vs. before the program (71 versus 29 percent).

Parents rated the overall usefulness of the smoking intervention program at 4.3 on a 5 point scale, with 5 being greatly useful. One-third of the parents who were offered the program said they were ready to consider quitting smoking, a higher rate than found in the general smoking population (20 percent). Their greater readiness was probably due to concern that their smoking was having a negative effect on their child's health.

For more details, see "A smoking cessation intervention for parents of children who are hospitalized for respiratory illness: The Stop Tobacco Outreach Program," by Dr. Winickoff, Valerie J. Hillis, Judith S. Palfrey, M.D., and others, in the January 2003 Pediatrics 111(1), pp. 140-145.

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