Hospital-Based Tobacco Interventions in Pediatric Settings

Background: Children exposed to tobacco smoke are at great risk for adverse health conditions leading to hospitalizations. Cessation interventions targeted at adult smokers in hospital settings have been shown to be effective in reducing smoking behavior. However, only a limited number of hospital-based interventions targeted at parent and household smokers have been described in the pediatric literature. Objective: The purpose of this article was to identify and compare successfully implemented pediatric hospital-based smoking cessation interventions, discuss outcomes, and identify strategies hospital-based providers can use in pediatric inpatient settings. Methods: We searched Medline, CINAHL, and Psychinfo databases for English language studies published in the last 20 years. Articles met inclusion criteria if the target population was limited to parent or household members of children admitted to a pediatric inpatient facility, and if the smoking cessation intervention was provided during the inpatient period and or initiated prior to discharge. Results: Of the 126 studies reviewed, 5 met inclusion criteria. Two were randomized control trials. Interventions used brief or intensive counseling and included: partnering with state resources, training pediatricians, and following-up with telephone counseling support. Outcome parameters included: enrollment into a referral program, completion of counseling sessions, quit attempts, smoking reduction, and smoking cessation. Conclusion: Our findings support the conclusion that hospital-based tobacco use cessation interventions for parents and household members of children admitted to a hospital are implementable by any level of health care provider, using a variety of intervention models. Although these preliminary reports are encouraging, objective outcomes and long term follow-up studies are still needed.