Background: Evidence from a 2004 national assessment of the extent to which NZ hospitals address the “5 As” identified reducing levels of intervention through the As, with the lowest levels of intervention in paediatric settings. The Smokefree Children project was designed to address the barriers to intervention by hospital paediatric staff and focus discussion on the needs of the child and not their parents' smoking.

Strategy: Using a family-centred care approach, 46 paediatric nurse representatives from 25 hospitals across New Zealand attended a one day workshop to prepare them to implement the Smokefree Children peer education programme. Participants were prepared to deliver a 24 slide presentation of essential understandings for addressing knowledge, attitudes and beliefs about smoking effects on child health and the benefits of intervention, and to introduce their colleagues to “Air Care” discussion with families using a simple Talk Card as a guide. Reporting was required for the first 3-5 sessions and the expectation was to involve 90% of staff. An initial yes/no assessment against a 23 item smokefree services standard, completed at the workshop, identified low evidence of best practice with affirmative responses for 14% of items. Five months after the workshops, 126 peer education sessions had been delivered and reported on, involving 867 paediatric nurse colleagues, 78% of whom rated the worth of the session highly (7-9/9) and 65% their confidence to act as high (7-9/9).

Conclusion: The “Air Care” approach is recommended as an acceptable way to engage paediatric staff and families in smokefree discussions.