Automated system boosts maternal smoking cessation in pediatric care

Secondhand smoke exposure among children can be significantly reduced by an automated tobacco treatment system for mothers integrated into routine pediatric care, according to a recent study published in Pediatrics.¹

Secondhand smoke exposure has been reported in more than 40% of US children, significantly increasing their risks of respiratory infections. However, the new data from Children’s Hospital of Philadelphia highlights a 3.9% absolute increase in smoking cessation among mothers, potentially protecting hundreds of thousands of children.¹

“We’ve created a system that removes the traditional barriers, such as provider time, prescribing challenges, and workflow burden," said Brian Jenssen, MD, MSHP, lead study author and an assistant professor at the University of Pennsylvania.¹

Tobacco screening intervention

The retrospective observational study was conducted to evaluate the population-level impact of an automated tobacco treatment system integrated into pediatric primary care.² Participants included parents whose children received care at any of the 12 participating study centers between June 2021 and August 2024.

Of these practices, 6 incorporated an electronic health record–linked parent tobacco treatment system. This program included screening, motivational messaging, and automatic treatment connection. Treatment connections included nicotine replacement therapy, SmokefreeTXT, and quit line referral.²

The other 6 practices incorporated only screening. Parents completing questionnaires during routine care were included, with self-reported smoking cessation rates measured as the primary outcome among those who reported smoking during the study period.²

Significant impact on mothers

There were 55,567 parents included in the final analysis, 49,595 of whom were mothers and 5972 were fathers. Smoking rates for mothers receiving care with vs without the system were 4.3% and 5.5%, respectively. For fathers, these rates were 6.5% and 8.3%, respectively.²

Smoking cessation rates were significantly improved among mothers who smoked during the study period receiving care with vs without the system, at 37.4% and 33.5%, respectively. In comparison, no significant difference was reported for fathers, with rates of 29.6% among both groups.²

Overall, these results highlighted a significant increase in maternal smoking cessation from an automated tobacco treatment system but no effect for fathers. Investigators concluded that this approach may reduce household tobacco use, improving pediatric preventive care.²

“By automating the screening, motivation, and connection to evidence-based treatment, we’re reaching parents at scale during a moment when they’re already focused on their child’s health,” said Jenssen.¹

Long-term risks of maternal tobacco use

The risks of maternal tobacco use have been well documented and include childhood neurocognition deficits when mothers smoke during pregnancy.³ In a cohort study, these children presented with reduced oral reading recognition scores vs their nonexposed counterparts (mean [SE] B = −1.2 [0.2]; P < .001).

Reductions in picture sequence memory (mean [SE] B = −2.3 [0.6]; P < .001) and picture vocabulary (mean [SE] B = −1.2 [0.3]; P < .001) tests were also reported. Exposed children also had reduced crystallized cognition composite scores (mean [SE] B = −1.3 [0.3]; P < .001) vs unexposed children.³

MRI also indicated smaller cortical areas in precentral, inferior parietal, and entorhinal regions among exposed vs unexposed children. Overall, the data highlighted the risks of maternal tobacco use during pregnancy.

“[This] may result in long-term consequences on [children’s] education and overall growth," wrote investigators.

References

1. Automated intervention shows significant increase in smoking cessation behavior. News release. Children’s Hospital of Philadelphia. March 17, 2026. Accessed March 18, 2026. https://www.eurekalert.org/news-releases/1119914
2. Jennsen BP, Jeffers AM, Nabi-Burza E, et al. An electronic health record–based tobacco treatment system for parents in pediatric primary care. Pediatrics. Published online March 17, 2026. doi:10.1542/peds.2025-073934
3. Fitch J. Maternal tobacco use tied to late childhood neurocognition deficits. Contemporary Pediatrics. February 13, 2024. Accessed March 18, 2026. https://www.contemporarypediatrics.com/view/maternal-tobacco-use-childhood-neurocognition-deficits