A Tale of Smoking Cessation Promotion: The Utilization of a Children's Book to Increase Screening and Counseling in the Pediatric Clinic

Clin Pediatr (Phila). 2017 Oct;56(12):1142-1147. doi: 10.1177/0009922816684607. Epub 2017 Jan 5.


Objectives: The rate at which pediatricians promote smoking cessation in clinical settings is low. The literature demonstrates that interventions paired with tangible health promotion materials may significantly increase screening rates to the pediatric office. The aim of this study was to investigate whether the addition of a children's book in the pediatric clinic could result in an increase in the rate in which pediatricians screened for secondhand smoke exposure (SHSe) and counseled caregivers to stop smoking.

Study design: This randomized controlled study was performed at 7 pediatric clinics.

Methods: Seven pediatric clinic sites were randomly assigned to either an intervention or control group. Pediatricians in the intervention group were given children's books about SHSe to distribute to their patients while the control group did not receive any materials.

Results: At baseline, there was no difference between the control group and intervention group in rates at which pediatricians screened for SHSe ( P = .8728) and counseled caregivers to stop smoking ( P = .29). After the intervention, screening for SHSe and counseling caregivers to stop smoking were statistically significantly greater in the intervention group, when compared to controls ( P < .01 and P < .001, respectively).

Conclusions: The use of a health promotion children's book in the pediatric setting can increase the rate at which pediatricians screen for SHSe and counsel caregivers to stop smoking. Future research should examine the effect of the storybook on various parameters of smoking cessation and future smoking behaviors.

Keywords: caregiver smoking cessation; children’s book intervention; smoking cessation; smoking cessation counseling; smoking cessation intervention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Books*
  • Child
  • Counseling*
  • Health Promotion / methods*
  • Humans
  • Parents*
  • Smoking Cessation*
  • Tobacco Smoke Pollution / prevention & control*


  • Tobacco Smoke Pollution