Counseling Parents to Quit Smoking: Little Evidence of Long-term Success

Since the publication of the National Tobacco Cessation Guidelines in 1996 by the Agency for Healthcare Research and Quality,¹ much work has been done to incorporate effective cessation interventions into medical practice. The adoption of brief cessation strategies by different types of medical practices has been a hallmark of this effort. The American Academy of Pediatrics has made an effort to encourage pediatricians and family physicians to address parent tobacco use during routine visits,^2- 3 while commentaries in pediatric journals have encouraged interventions for parents who smoke.^4- 5 Perez-Stable et al⁶ stated that "physician visits for young children present an opportunity to effect behavior change among smoking parents." In an accompanying editorial, Christakis⁴ concludes that "there are notoriously few things that we do as part of well-child care for which there is sound evidence of benefit. Smoking cessation counseling is among them." Unfortunately, such recommendations are based on an extrapolation of the strong evidence supporting outpatient interventions in adult primary care rather than on studies in the pediatric setting. To date, there are no published studies demonstrating sustained (1-year) smoking cessation arising from brief pediatric office interventions.