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While summarising the US Third National Health and Nutrition Examination Survey,1 Archivist suggests that in Britain many paediatricians would view smoking cessation promotion as being the province of the general practitioner.2 Given the strong relation between environmental tobacco smoke exposure and respiratory illness in children, we feel it essential that all those who care for children are involved in the active promotion of smoking cessation.
We have presented data from a pilot smoking cessation study conceived by paediatricians but performed in primary care.3 Adult female smokers registered with a general practice in Newcastle upon Tyne were identified. Smokers in each of three age matched groups (mothers of asthmatic children, mothers of children without asthma, and women without children) were approached and invited to take part in a smoking cessation study. The smoking cessation interventions, which included nicotine replacement patches and brief motivational interviews, were delivered by practice nurses. Table 1 shows the number of women contacted in each of the three groups, the number agreeing to participate, and the number not smoking (verified by salivary cotinine measurement) after 12 weeks.
While there was no significant difference in cessation rates between the three groups once subjects had been recruited, there was a difference between the likelihood of contacted women wishing to participate in the study. Mothers of asthmatic children were more likely to volunteer than mothers of children without asthma (OR = 1.8; 95% CI: +0.8 to +3.7) or adult women without children (OR = 2.6; 95% CI: +1.2 to +5.6). It can been seen that, in order to achieve one successful cessation at 12 weeks, far fewer mothers of asthmatic children had to be contacted than mothers of non-asthmatic children and women without children.
Although the actual support of adults trying to stop smoking may be undertaken in a primary care setting (often by practice nurses), paediatricians should not underestimate their potential influence in affecting parents' decisions regarding trying to stop smoking. Mothers of children with respiratory illness may be already further around the cycle of behaviour change4 than other adults. Encouragement from their child's paediatrician may prove the spur to them finally trying to stop smoking.