Smoking cessation counseling by pediatricians in an inner-city setting

Objective: To assess mothers' perceptions of pediatrician-provided smoking cessation counseling. Design: Cross-sectional, descriptive study. Setting: Waiting rooms of five ambulatory pediatric clinics in the Bronx, NY. Participants: Convenience sample of 115 mothers. Main Outcome Measures: A structured questionnaire assessed the smoking history of the subject, presence or absence of environmental tobacco smoke(ETS)-related conditions in the subject's youngest child, and extent of smoking cessation counseling by the pediatrician. Subjects were asked whether they had been 1) asked about smoking; 2) advised about the risks of ETS exposure; 3) assisted in smoking cessation; and 4) arranged for a follow-up appointment to discuss smoking cessation. Results: Overall, 73% of mothers reported being asked about smoking by their child's pediatrician, and 50% reported being advised about the effects of ETS exposure. Of the 26 smokers in the sample, only two reported being assisted in smoking cessation. None reported being arranged for a follow-up appointment. Mothers of children with ETS-related conditions reported a higher rate of assessment for smoking status (ask: 85% vs. 63%, p=.01; advise: 57% vs. 43%, p=.19). Conclusions: Mothers in our setting report a high level of inquiry into their tobacco use, especially when they have children with ETS-related conditions. While they also report receiving advice about the risks of ETS exposure, smokers are very infrequently assisted in smoking cessation.