January 10, 2003

Child hospitalizations good time to get parents to stop smoking

Children admitted to the hospital for respiratory illnesses often suffer from second-hand smoke exposure caused by parental smoking. MGH researchers have found that hospitalizations can be good times to address parental smoking and smoking cessation. As reported in a study in the January 2003 issue of Pediatrics, researchers were able to help many parents stop smoking and gain a better awareness of the harm passive smoke can inflict on their children.

"Until now, pediatricians have been hesitant to address smoking when parents are stressed about their child being sick," says lead author Jonathan Winickoff, MD, MPH, of the MGH Center for Child and Adolescent Health Policy. "But the results show that parents are very receptive to the intervention."

The researchers worked with collaborators at Boston Children's Hospital. During the four-month study, the parents of children admitted to Children's with respiratory illness were invited to participate in the Stop Tobacco Outreach Program (STOP), which included an initial motivational interview, written materials, nicotine replacement therapy, phone counseling and referral to the parents' own primary care physician. Of the 71 smoking parents enrolled in the study, 80 percent completed all counseling sessions, and 56 percent accepted free nicotine replacement therapy at the time of enrollment. After two months, half reported making an attempt to quit that lasted at least 24 hours, and 20 percent reported sustained tobacco abstinence, significantly more than the overall U.S. cessation rate of 2 to 3 percent.

"All of the parents in the study said that STOP should be offered to parents who smoke at the time a child is hospitalized," Winickoff says. Nancy Rigotti, MD, director of the Tobacco Research and Treatment Center at the MGH, was the study's principal investigator, and other team members were Valerie Hillis and James Perrin, MD, of MGH, and Judith Palfrey, MD, of Children's Hospital.