Why Pediatricians May Be Best Equipped to Help Smokers Quit

Parents with kids are most likely to respond to interventions to get them to stop smoking, and pediatricians have many opportunities.


About one out of every four parents with small children responds to interventions to help them quit smoking, which is slightly better than the one in five parents who would quit without any special help, according to a new study. Researchers say the results should encourage pediatricians to take advantage of their frequent encounters with parents, and try to get them to start a smoking cessation program.

"Because (pediatricians) can make use of the teachable moment of a child's vulnerability to tobacco smoke, they may provide added benefit to helping this group of smokers quit," said lead author Dr. Jonathan Winickoff, a professor at Massachusetts General Hospital and Harvard Medical School.

Winickoff and his colleagues combined the results of 18 different studies of smoking cessation programs aimed at more than 7,000 parents. The studies included either medications, counseling, or self-help materials, or some combination of the different approaches to quitting. Most of the studies included an intervention in the hospital, a well-baby clinic, or a pediatrician's office.

The 18 studies followed parents for anywhere between several months and more than a year, and measured whether those who received the smoking interventions were more likely to quit than parents who didn't get any additional help. Only four of the studies found that the interventions improved the parents' quit rates.

When the findings from all the studies were combined, 23.1 percent of the parents who received the anti-smoking aids successfully quit, while 18.4 percent in the other group gave up smoking. In studies that included medications, parents were three times as likely to quit as parents who didn't take the drugs.

The authors write in their report that the gains from the smoking cessation programs were "modest," but Winickoff said they are worth pursuing. "These are short-term studies," Winickoff told Reuters Health. "There are stages of change and (parents') readiness to quit. Over time we will enable almost every parent to quit smoking."

"We know it takes multiple attempts over time," said Sue Curry, dean of the University of Iowa College of Public Health, who was not involved in this study. "To me (the study) says that we need to have realistic expectations, and we need to make sure we celebrate the successes of smokers that go through the process," Curry told Reuters Health.

One of Curry's studies was included in the current analysis, which is published in the journal Pediatrics. Her research found that mothers who were given a quitting guide along with in-person advice and phone counseling from nurses were twice as likely to quit as mothers who didn't receive this intervention.

Her study originated in a pediatric clinic, which Winickoff said is a good place to intervene with parents' smoking habits. Given that parents of young children frequent the pediatrician's office for routine check-ups and vaccinations, kids' doctors should screen parents for smoking and help them find resources to stop.

Winickoff added that helping parents to quit smoking could have an enormous impact not only on their own health, but on the health of their children. Another paper in the same issue of Pediatrics, for instance, found that children whose parents smoked during the pregnancy have thicker arterial walls, which is linked with a higher risk of cardiovascular disease. Smoking is "associated with pneumonia, asthma, developmental delay, school absenteeism, dental decay, sudden infant death, hearing loss, and a range of other illnesses that are too numerous to list," he said.

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