Smoking cessation interventions for parents of children with chronic disease: A systematic review and meta-analysis of randomised controlled trials

AIMS: To evaluate the effectiveness of smoking cessation interventions and identify essential/effective components that contribute to successful cessation among parents of children with chronic disease. REVIEW METHODS: A systematic search of seven electronic databases was conducted from inception to December 2025. Eligible studies included randomised controlled trials evaluating smoking cessation interventions targeting parents who smoke and have children with chronic disease. A fixed-effect meta-analysis using the Mantel-Haenszel method was conducted to calculate risk ratios with 95% confidence intervals. RESULTS: Ten studies involving 3758 participants were included. Six combined nonpharmacological interventions with nicotine-replacement therapy, while four used nonpharmacological interventions alone. Nonpharmacological interventions were categorised as motivational interviewing-based interventions or behavioural therapy. The pooled results showed that the interventions significantly increased self-reported 7-day point prevalence abstinence immediately post-intervention and at first follow-up, but effects were not sustained at second follow-up, indicating stronger short-term than long-term effectiveness. Biochemically validated abstinence and continuous abstinence showed limited or inconsistent effects across studies. Subgroup analyses showed that motivational interviewing-based interventions maintained significant effects at first follow-up, and that interventions incorporating child-specific health information were more effective immediately post-intervention. No significant reduction in children's second-hand smoke exposure was observed across studies. CONCLUSION: Interventions that incorporate motivational interviewing and personalised, child-specific health information, including feedback on children's second-hand smoke exposure, demonstrate positive effects in promoting abstinence among parents of children with chronic disease, with moderate strength evidence. Hospital visits may provide optimal "teachable moments", positioning nurses to play a central role in engaging parents in smoking cessation efforts.