Advising Parents to Stop Smoking: Pediatricians' and Parents' Attitudes

¹ From the Departments of Pediatrics Vermont Cancer Center, Burlington
² From the Departments of Medical Biostatistics University of Vermont, Burlington
³ From the Departments of Office of Health Promotion Research, University of Vermont, Burlington Vermont Cancer Center, Burlington

Pediatricians are in a unique position to address the issues of smoking cessation with parents. Vermont pediatricians and parents of their patients were surveyed to assess attitudes about giving and receiving smoking cessation advice. A questionnaire was mailed to all pediatricians in Vermont, and 72 valid responses were received, for a response rate of 91%. Forty percent of pediatricians routinely took a smoking history from parents and 11% recorded this information in the child's chart. Most pediatricians (94%) reported advising at least 60% of smoking parents to quit, and they spent an average of 4.4 minutes doing this. Barriers to giving advice were lack of time (42%), feeling that parents did not expect advice (25%), and feeling ill at ease giving the advice (25%). Only 8.5% of pediatricians had received training in how to give smoking cessation advice, but 87% were willing to learn methods to give advice briefly. Six hundred seventy-six parents from randomly selected pediatric practices were interviewed. The average parental age was 32, and 84% were women; 49% had never smoked, 30% were former smokers, and 21% were current mokers. Current smokers were less likely to agree with statements about the adverse effects of passive smoke on children. Most parents (56%) felt that pediatricians should give quit-smoking advice to parents, and 52% of smoking parents reported that they would welcome advice. Only 30% of current smokers said advice would bother them somewhat, and 15% had more negative reactions. Parents and pediatricians agreed on the best opportunities to give quit-smoking advice. Since 91% of parents said they intended to quit smoking sometime, and since pediatrician-delivered quit-smoking advice would be acceptable to them, it would be worthwhile for pediatricians to learn methods of delivering advice succinctly.

Key Words: smoking • smoking cessation • passive smoking

Submitted on March 23, 1992
Accepted on July 30, 1992

This article has been cited by other articles:

				J. P. Winickoff, E. R. Park, B. J. Hipple, A. Berkowitz, C. Vieira, J. Friebely, E. A. Healey, and N. A. Rigotti Clinical Effort Against Secondhand Smoke Exposure: Development of Framework and Intervention Pediatrics, August 1, 2008; 122(2): e363 - e375. [Abstract] [Full Text] [PDF]

				D. S. Blumenthal Barriers to the Provision of Smoking Cessation Services Reported by Clinicians in Underserved Communities J Am Board Fam Med, May 1, 2007; 20(3): 272 - 279. [Abstract] [Full Text] [PDF]

				A. V. Prokhorov, J. P. Winickoff, J. S. Ahluwalia, D. Ossip-Klein, S. Tanski, H. A. Lando, E. T. Moolchan, M. Muramoto, J. D. Klein, M. Weitzman, et al. Youth Tobacco Use: A Global Perspective for Child Health Care Clinicians Pediatrics, September 1, 2006; 118(3): e890 - e903. [Abstract] [Full Text] [PDF]

				J. P. Winickoff, S. E. Tanski, R. C. McMillen, B. J. Hipple, J. Friebely, and E. A. Healey A National Survey of the Acceptability of Quitlines to Help Parents Quit Smoking Pediatrics, April 1, 2006; 117(4): e695 - e700. [Abstract] [Full Text] [PDF]

				J. P. Winickoff, S. E. Tanski, R. C. McMillen, J. D. Klein, N. A. Rigotti, and M. Weitzman Child Health Care Clinicians' Use of Medications to Help Parents Quit Smoking: A National Parent Survey Pediatrics, April 1, 2005; 115(4): 1013 - 1017. [Abstract] [Full Text] [PDF]

				J. P. Winickoff, A. B. Berkowitz, K. Brooks, S. E. Tanski, A. Geller, C. Thomson, H. A. Lando, S. Curry, M. Muramoto, A. V. Prokhorov, et al. State-of-the-Art Interventions for Office-Based Parental Tobacco Control Pediatrics, March 1, 2005; 115(3): 750 - 760. [Abstract] [Full Text] [PDF]

				J. P. Winickoff, R. C. McMillen, B. C. Carroll, J. D. Klein, N. A. Rigotti, S. E. Tanski, and M. Weitzman Addressing Parental Smoking in Pediatrics and Family Practice: A National Survey of Parents Pediatrics, November 1, 2003; 112(5): 1146 - 1151. [Abstract] [Full Text] [PDF]

				S. E. Tanski, J. D. Klein, J. P. Winickoff, P. Auinger, and M. Weitzman Tobacco Counseling at Well-Child and Tobacco-Influenced Illness Visits: Opportunities for Improvement Pediatrics, February 1, 2003; 111(2): e162 - 167. [Abstract] [Full Text] [PDF]

				I. Sharif, T. Oruwariye, R. Cohen, and P. O. Ozuah Effectiveness of Clinician Training in Smoking Cessation Counseling Arch Pediatr Adolesc Med, September 1, 2002; 156(9): 944 - 945. [Full Text] [PDF]

				A. Malarcher, A. Easton, C. Husten, and E. Frank Smoking Cessation Counseling: Training and Practice Among Women Pediatricians Clinical Pediatrics, June 1, 2002; 41(5): 341 - 349. [Abstract] [PDF]

				D. A. Christakis Parental Smoking Cessation Counseling: It's About Time Arch Pediatr Adolesc Med, January 1, 2001; 155(1): 15 - 16. [Full Text] [PDF]

				E. J. Perez-Stable, M. Juarez-Reyes, C. P. Kaplan, E. Fuentes-Afflick, V. Gildengorin, and S. G. Millstein Counseling Smoking Parents of Young Children: Comparison of Pediatricians and Family Physicians Arch Pediatr Adolesc Med, January 1, 2001; 155(1): 25 - 31. [Abstract] [Full Text] [PDF]

				R. J. Stein, C. K. Haddock, K. K. O'Byrne, N. Hymowitz, and J. Schwab The Pediatrician's Role in Reducing Tobacco Exposure in Children Pediatrics, November 1, 2000; 106(5): 66e - 66. [Abstract] [Full Text]

				J. A. Hopper and K. A. Craig Environmental Tobacco Smoke Exposure Among Urban Children Pediatrics, October 1, 2000; 106(4): 47e - 47. [Abstract] [Full Text]

				S. M Van't Hof, M. A Wall, D. W Dowler, and M. J Stark Randomised controlled trial of a postpartum relapse prevention intervention Tob. Control, September 1, 2000; 9(90003): 64i - 66. [Full Text]

				P. M Lantz, P. D Jacobson, K. E Warner, J. Wasserman, H. A Pollack, J. Berson, and A. Ahlstrom Investing in youth tobacco control: a review of smoking prevention and control strategies Tob. Control, March 1, 2000; 9(1): 47 - 63. [Abstract] [Full Text] [PDF]

				J. Kemm, L. Irvine, I. K Crombie, R. A Clark, and P. W Slane Smoking by parents of asthmatic children BMJ, September 4, 1999; 319(7210): 644 - 644. [Full Text]

				K. F. Burnett and P. C. Young Ask, Advise, Assist: Pediatricians and Passive Smoke Exposure Clinical Pediatrics, July 1, 1999; 38(6): 339 - 345. [Abstract] [PDF]

				J. G. Zapka, K. Fletcher, L. Pbert, S. K. Druker, J. K. Ockene, and L. Chen The Perceptions and Practices of Pediatricians: Tobacco Intervention Pediatrics, May 1, 1999; 103(5): 65e - 65. [Abstract] [Full Text]

				R. S. Kahn, P. H. Wise, J. A. Finkelstein, H. H. Bernstein, J. A. Lowe, and C. J. Homer The Scope of Unmet Maternal Health Needs in Pediatric Settings Pediatrics, March 1, 1999; 103(3): 576 - 581. [Abstract] [Full Text]

				M. J. Ashley and R. Ferrence Reducing children's exposure to environmental tobacco smoke in homes: issues and strategies Tob. Control, March 1, 1998; 7(1): 61 - 65. [Abstract] [Full Text]

				K. A. Daly, R. E. Selvius, and B. Lindgren Knowledge and Attitudes About Otitis Media Risk: Implications for Prevention Pediatrics, December 1, 1997; 100(6): 931 - 936. [Abstract] [Full Text] [PDF]