We all know that smoking is detrimental to one’s health, but how often does a smoker consider the health of those around them, especially children?  When I was in nursing school I had the opportunity to do a training rotation with a pediatrician who was very aggressive in dealing with smoker parents of kids who frequently had respiratory tract infections, asthma or bronchitis.  He would send hand-written letters home to the parents pointing out that while he was trying to keep these kids healthy, the parents’ habit was the main cause of the ongoing medical problems suffered by their children.

While I don’t propose that we go to the extreme of pointing the finger of blame at parents, I do think that we have an obligation to make parents aware that smoking can directly affect the health of their children.

As a triage nurse in Whidbey General Hospital’s Emergency Department, I frequently evaluate children with asthma or other reactive airway diseases. In such cases I ask if anyone in the family smokes, and parents will frequently answer that one or both of them do smoke, but “never in the house or car or around the children.” Most parents believe this is enough, and are surprised to discover that in reactive airway diseases such as asthma, an attack can be triggered simply by the smell of cigarette smoke lingering on clothing.

Rather than simply nagging at parents who smoke (or anyone who smokes for that matter), our ED personnel have recently begun offering resources to help them successfully quit. Whidbey General Hospital’s Tobacco Cessation Program offers individualized counseling and free classes to help smokers stop. Those who complete the class are given a coupon for free nicotine patches to help them get started.

When a patient is identified as a smoker (or living with a parent, spouse or partner who smokes), we ask if they are interested in quitting. Those who are interested are added to a list and contacted later by a representative of the Tobacco Cessation Program and invited to attend the class. 

Since we have implemented this program in ED triage, I’ve found that most smokers are at least interested in quitting, but many of them feel they just can’t do it. We can now offer them assistance rather than criticism, and for parents, the possibility of keeping their kids healthier is an added incentive.

I’ve had a number of parents express a renewed interest in quitting once they’ve realized the connection between their children’s illnesses and frequent cigarette smoke exposure.