Identifying hospitalised children living with adults who smoke cigarettes: assessing prevalence and admission practices.

Abstract

Background: The Royal Australian College of General Practitioners recommends that all parents/carers of hospitalised children are asked about their smoking status by health professionals as part of routine care. However, international literature suggests that addressing smoking status in this group is not consistently performed by health professionals. Aim: To explore the prevalence and identification of hospitalised children who are exposed to second-hand cigarette smoke in their home. Methods: This prospective observational study was conducted in two parts: Part 1 utilised a cross-sectional survey to identify the proportion of children admitted to a regional general paediatric unit who live with adults who smoke cigarettes. Parents/carers of children admitted between April to September 2021 were invited to participate in the survey during the standard nursing admission process. Part 2 involved a survey across 15 metropolitan and regional public health services to determine if identification of parent/carers’ smoking status is a routine part of the standard paediatric admission process. Results: 453 parent/carer responses were obtained from 782 consecutive new admissions (response rate: 58%). Nearly a third of respondents (n=136, 30%) indicated that their child, requiring hospital admission, lived with at least one parent/carer who identified as a current cigarette smoker. Of the 15 health services surveyed, four (27%) nursing units reported routinely asking parents/carers about their smoking status as part of the standard admission process. Only 11 of the 15 health services had a dedicated clinical pharmacy admissions service. No pharmacists reported routinely assessing parent/carer smoking status at admission. Discussion: Admission to hospital provides an opportunity to enhance care for children by addressing nicotine dependence within their families. Findings suggest routine recording of smoking status can be improved. This would allow for progression of smoking cessation interventions to drive quit attempts in parents/ carers of children admitted to hospital.