Parental smoking cessation to protect young children: a systematic review and meta-analysis.
BACKGROUND
Young children can be protected from much of the harm from tobacco smoke exposure if their parents quit smoking. Some researchers encourage parents to quit for their children's benefit, but the evidence for effectiveness of such approaches is mixed.


OBJECTIVE
To perform a systematic review and meta-analysis to quantify the effects of interventions that encourage parental cessation.


METHODS
We searched PubMed, the Cochrane Library, Web of Science, and PsycINFO. Controlled trials published before April 2011 that targeted smoking parents of infants or young children, encouraged parents to quit smoking for their children's benefit, and measured parental quit rates were included. Study quality was assessed. Relative risks and risk differences were calculated by using the DerSimonian and Laird random-effects model.


RESULTS
Eighteen trials were included. Interventions took place in hospitals, pediatric clinical settings, well-baby clinics, and family homes. Quit rates averaged 23.1% in the intervention group and 18.4% in the control group. The interventions successfully increased the parental quit rate. Subgroups with significant intervention benefits were children aged 4 to 17 years, interventions whose primary goal was cessation, interventions that offered medications, and interventions with high follow-up rates (>80%).


CONCLUSIONS
Interventions to achieve cessation among parents, for the sake of the children, provide a worthwhile addition to the arsenal of cessation approaches, and can help protect vulnerable children from harm due to tobacco smoke exposure. However, most parents do not quit, and additional strategies to protect children are needed.
Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, Ramat Aviv, Israel. rosenl@post.tau.ac.il
Laura J
LJ
Rosen
Michal Ben
MB
Noach
Jonathan P
JP
Winickoff
Mel F
MF
Hovell
D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003376:Counseling; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents; D016540:Smoking Cessation; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000517:prevention & control
D014028:Tobacco Smoke Pollution