Objective: To characterize smoking behaviors of caregivers whose children attend a large urban pediatric primary care center.
Design: Descriptive survey. Women (n = 479) classified as smokers completed a questionnaire including demographics, smoking habits, measures of addiction, social reinforcers for smoking, attitudes and knowledge, other health and safety habits, and the pediatrician's role in smoking cessation counseling.
Results: Of 1421 women surveyed, 36.6% (517) were classified as daily smokers. Four hundred and seventy-nine (93%) were enrolled in the study. Thirty-eight (7%) refused or were ineligible. Smokers differed significantly from non-smokers, with smokers more likely to have lower incomes (p<.03), lower educational attainment (p<.001), and were more likely to be white than non-smokers (p<.001). The average smoker smoked 14 cigarettes per day for 10 years. Half of the subjects had not considered quitting smoking in the near future. The majority of subjects (66%) lived with at least one other smoker, and reported that more than half of their friends smoked. Most (79%) participants agreed that pediatricians should give smoking cessation advice to parents of their patients. However, only 19% recalled being counseled to quit, and 55% recalled their child's doctor discussing the danger of environmental tobacco smoke.
Conclusion: The pediatric visit is an excellent opportunity for identifying women who smoke. Efforts to assist women with smoking cessation in similar settings will need to take into account their poverty and the high degree of social support for their continued smoking.