Impact of a brief peri-operative counselling session on parental awareness of passive smoking in paediatric ambulatory surgery

BACKGROUND Exposure to second-hand smoke (SHS) from parents increases paediatric peri-operative respiratory risk, yet peri-operative screening and counselling are rarely implemented. OBJECTIVE To assess whether a single brief counselling session delivered during the paediatric ambulatory surgery pathway increases parental awareness of SHS harms and influences short-term self-reported behaviour. DESIGN Prospective observational before–after study with 30-day follow-up. SETTING Single-centre tertiary-level university hospital ambulatory surgery unit, Liège, Belgium; data collected from 7 November 2024 to 27 March 2025. PATIENTS Parents who self-reported active tobacco use and whose child was scheduled for elective paediatric ambulatory surgery at the University Hospital of Liège, Belgium. Of 43 eligible dyads, 31 parents consented and completed baseline and immediate postintervention questionnaires; 26 completed 30-day follow-up. INTERVENTION One standardised ~15-min counselling session by a certified tobacco counsellor covering types of smoke exposure, health and anaesthetic risks and practical measures to reduce household exposure. MAIN OUTCOME MEASURES Primary outcome was change in a summed awareness score (six items, 0 to 10 each; total 0 to 60) from precounselling to immediate postcounselling. Secondary outcomes included item-level changes, session acceptability and self-reported behavioural change at 30 days. RESULTS A brief peri-operative counselling session markedly improved parental awareness of SHS. At 30 days, self-reported behavioural change remained modest. The awareness score was exploratory and not formally validated. Randomised studies with objective exposure measures and longer follow-up are needed. CONCLUSION A single brief peri-operative counselling session improved parental awareness of SHS harms, with limited short-term impact on self-reported behaviour. TRIAL REGISTRATION NCT07144982. Approved by the Comité d’Ethique Hospitalo-Facultaire Universitaire de Liège; President: Professor D. Ledoux; IRB number: 707 (Belgian ref. B7072024000085; internal ref. 2024/327).