Background: Preventative medicine within the paediatric cohort is an important but difficult area due to the parental impact on a child’s health. Smoking cessation has long been recognised as a key area of preventative medicine, not only improving the health of the person smoking themselves, but also of those around them. Research indicates children exposed to smoke experience increased attack frequency and greater instances of life-threatening bronchospasm. As resources show that over half of smokers are aiming to quit, and every hospital attendance due to an asthma/wheeze exacerbation is considered a failure in asthma management, every opportunity should be taken during a child’s attendance to instigate changes that will prevent future exacerbations, with parental smoking cessation being a key area upon which to focus.Aims: This is a Quality Improvement Project conducted in a large central London hospital aiming to determine the percentage of the parents of children presenting with wheeze or asthma who smoke, and what proportion of these were offered smoking cessation advice. Subsequently, aiming to formulate resources to enable and empower clinicians to provide cessation advice.Method: Interrogation of clinic databases and the regional electronic care record identified patients presenting to St Mary’s Hospital (SMH) Paediatric Emergency Department (PED) between September and October 2024, who coded a diagnosis of viral-induced-wheeze/wheeze/asthma on their discharge summary.We then analysed the clinician documentation from the attendance to elicit whether a parental smoking history was documented, and whether there was documented evidence of smoking cessation advice provided. A patient/carer directed information poster focusing on the impact of parental smoking on childhood wheeze was then created and placed in clinical areas with a link to a QR code to allow patients to scan and download a smoking cessation leaflet.Results: Over the two-month period, 223 patients presented to SMH PED coded as having a diagnosis of viral-induced wheeze or asthma. In 30% of these cases, a parental smoking history was documented, of which 24% were smokers. Only 12.5% of parents documented to have been smokers were documented as having been offered smoking cessation advice. Following my creation of a smoking cessation information poster directing parents and guardians to borough-specific smoking cessation resources, there has been a six-fold increase in the number of carers offered patient-specific smoking cessation advice.Conclusion: Evidence suggests that improving parental knowledge about the impact of smoking on their children with wheeze may improve the likelihood of them seeking smoking cessation advice, especially when encouraged by clinicians at a time when their child has required hospital treatment. Given the impact second-hand smoke has on all populations, not only those in the paediatric cohort, preventative medicine through smoking cessation advice is a key target area for improving global health, especially in areas of lower socio-economic backgrounds where smoking rates are highest.This project shows that if smoking cessation advice is readily available, parents do readily seek to engage with it, which will hopefully have a positive knock-on impact to all those around them, especially those in the paediatric cohort.
