Offering smoking cessation to parents during pediatrician visits can increase quit rates, according to a recent study in Pediatrics.

Mothers who reported smoking in routine pediatric screening questionnaires and were presented with automated support through their child’s electronic health record (EHR) were 11.6% more likely to quit smoking than those who did not receive the notifications.

“Many people who smoke are underserved medically or don’t have access to regular, ongoing services, but come and see us regularly in pediatric primary care — up to four to six times a year for routine care” for their children, said Brian Jenssen, MD, MSHP, primary care pediatrician and researcher at the University of Pennsylvania in Philadelphia, who led the study. “They want us to intervene to help them. And plenty of our research shows that framing this around helping their child is very motivational.”

Parents are the most common source of childhood exposure to secondhand smoke. Such exposure increases risk for sudden infant death syndrome and chronic respiratory diseases that persist into adulthood. Children whose parents smoke are also more likely to do so as teenagers.

The US Preventive Services Task Force recommends all clinicians ask adults about their tobacco use and advise them to quit. However, parents rarely receive tobacco cessation services in pediatric settings, Jenssen said.

Jenssen and his team conducted a secondary retrospective observational study of data from a clinical trial conducted between 2021 and 2024 at 12 pediatric centers within the Children’s Hospital of Philadelphia Care Network in Philadelphia. Parents who had completed at least one tobacco screening but were not enrolled in the original trial were included in the new analysis.

Six of the clinics implemented the protocols for EHR-based treatment, which started with a screening questionnaire before the appointment. If the parent indicated they had smoked tobacco within the previous week, motivational messaging about the dangers of secondhand smoke for children appeared on the screen.

Parents could sign up for three treatment options: nicotine replacement therapy, a text messaging service offering motivation and reminders to quit, and a quitline. If the parent signed up for therapy, a pharmacy shipped nicotine patches, gum, or lozenges to their home.

Parents at six clinics in the control group received tobacco screening but were not offered the treatment options.

The secondary analysis comprised data from 55,567 parents (49,595 mothers, 52% in the treatment group; 5972 fathers, 54% in the treatment group). Children were mostly younger than 2 years (42%) and White (46%).

Complete quit rates at their final follow-up visit were 11.6% higher among mothers at intervention clinics than among those in the control group (37.4% vs 33.5%; P = .044). A little over one half of mothers at intervention clinics accepted one or more of the treatment options.

Fathers who smoked were less likely to quit, with no difference in cessation rates between those in the treatment and control groups, but the sample was too small to draw statistically significant conclusions (29.6% for both; P = 1.0).

“This might be something that’s more motivational for the mom. Dads may need something different,” Jenssen said.

Because the treatment options were embedded in EHRs, health clinics might easily implement the intervention without placing additional demands on pediatricians, Jenssen said.

Addressing tobacco use of caregivers in pediatric care is an effective way to prevent harm in children, said Ashley Merianos, PhD, professor of human services at the University of Cincinnati in Cincinnati, and a researcher on the harms to children of secondhand smoke.

“This electronic record-based system takes something that can easily be missed during pediatric healthcare visits and makes it routine,” Merianos said. “Although parents are not the patients, their tobacco use can directly affect their children’s health.”

Jenssen reported receiving grant funding from the National Institutes of Health for this study. Merianos reported having no financial conflicts of interest.

Kelsey Mesmer, PhD, is a freelance journalist and journalism professor at Saint Louis University in St. Louis.