The present study is the first of which we are aware that has surveyed the smoking habits of parents attending a children's hospital in the UK. The main finding was that smoking parents expressed a strong desire to quit. The study also reports on factors relevant to parents that will be important to the development of a smoking cessation programme for parents.
This study has demonstrated that the 27% prevalence of smoking among parents (mostly mothers) attending hospital with their child was higher than for adults in the local population. The 2002 Grampian Adult Lifestyle Survey reported regular smoking among 20% of women and 34% of men aged 25–34 and among 22% of women and men aged 35–44 years. Smoking and childhood morbidity are both associated with low socioeconomic status, which may explain the relatively higher prevalence of smokers among those surveyed. As very few parents refused to complete the survey, it is unlikely that refusal by smoking parents to participate created a substantial bias.
Some of the results of our survey may influence the design of a smoking cessation programme. First, preparedness to quit among smoking parents did not differ significantly across the clinical areas; a study from North American4
has been interpreted as indicating admission to hospital is a unique opportunity to enrol parents who smoke into cessation programs, but our results suggest that recruitment into an intervention study is unlikely to be increased by focussing on parents of children who are inpatients. Second, there was no indication that preparedness to quit was more likely in parents of children with respiratory illnesses, a finding which was not consistent with the results of a study in the USA5
where parents of children with respiratory illnesses were more motivated to quit. The numbers of participants included in the present study were comparable to those included in the American studies,4,5
but our study may have been underpowered to detect minor differences in preparedness to quit between parents of children admitted to hospital or with respiratory conditions and other parents. Third, the survey showed that in this predominantly female population, delivery of child care was not needed as part of a smoking cessation programme; presumably partners or other relatives would care for the children in the evenings when the majority preferred to attend for smoking cessation advice. Fourth, based on the survey findings we will not involve the children as part of the smoking cessation advice, in contrast with studies in the USA where children of smokers are taught about the adverse health effects of smoke exposure and encouraged to ask parents not to smoke in the car and house.
Our study confirmed the findings of other studies where smokers have been found to be more likely to have parents who smoke, and this assures us that smoking cessation has the potential to interrupt a family history of smoking to the benefit of future generations. Our study also found that partners of a majority of smoking parents also smoked. Successful smoking cessation in one parent may be of limited benefit to children if a second adult in the house continues to smoke, and intervention studies will need to address this important issue.