Advising Parents with Asthmatic Children☆

The article “Are Pediatric ED Nurses Providing Tobacco Cessation Advice to Parents?” in your September 2009 issue caught my attention.

I just finished my pediatric and mother-baby clinical rotations in a hospital located in a moderately sized city where many vulnerable populations seek care. It was astonishing to see how many new mothers were stepping outside for a cigarette soon after giving birth and to experience the overwhelming aroma of cigarette smoke when walking into a closed room where pediatric patients were being treated. Given the many negative implications of smoking, I believe it is all too prevalent, especially in homes where young children are directly in contact with environmental tobacco smoke. As a soon-to-be nurse who is interested in working with the pediatric population, I believe nurses have an important obligation to be an advocate for this vulnerable population. Sometimes that means treating not only the children but also the parents.

Two studies related to this topic caught my attention as well. Reading1 did a study of more than 500 families with asthmatic children in homes where the children were exposed to environmental smoke. Findings revealed that even after parents were educated about the negative effect of environmental smoke on their children's health, after 1 year, 98% of the parents still smoked. It was concluded that to help parents quit smoking, they may need to be educated not only about how smoking affects their children's health but how it affects their own health.

These results were surprising, but perhaps parents are not receiving the right education or do not fully understand the negative outcomes. A study conducted by Robinson and Kirkcaldy2 examined why parents continue to smoke even when they know their child's health could be adverse affected. The study found that the incidence of parental smoking actually declined from the time their child was between 0 to 6 months of age but often increased after the child was older than 6 months. The reason parents gave for resuming smoking was that they believed a newborn baby's lungs could not handle smoke but that their lungs would be able to tolerate it as they got older, which obviously indicates a knowledge deficiency.

The article in your September issue was unique in that it catches parents in a place where emotions are high, and they know the well-being of their child is at risk. Perhaps the message about environmental smoke and asthma correlation would be more likely to be embraced if appropriate education was provided at that time. The article noted that only a small percentage of nurses are assessing the smoking status of parents of children with asthma and that even fewer are encouraging parents to quit smoking. However, many nurses expressed interest in learning more about teaching parents and even believed they could be a positive influence in the fight to stop smoking. With this finding in mind, hospitals could possibly create a protocol to provide nurses with the steps to take when encountering this problem. Based on the aforementioned evidence, nurses could teach parents about the negative effect of smoking on their child's health and could also provide pamphlets with information about how smoking affects their own health. Having readily available support group information would be a further asset.

Anything we can do to help spread the word about smoking and further protect the generations to come is worth the extra effort.