A family-based smoking cessation tool kit

We have created a unique tool kit for facilitating conversations and decisions about tobacco cessation. We hope to open communication and facilitate referrals for tobacco control through this family-based initiative.

The tool kit is a trifold folder that has three options:

  • Green (quit for good),
  • Yellow (cut back and consider quitting at a later date),
  • Red (not ready to quit but ready to decrease secondhand smoke exposure).


During a child’s medical visit, we inquire about secondhand smoke exposure and address it through this decision aid tool kit. This tool kit is offered to families while a clinical during the rooming process if there is any one in the family that smokes tobacco. Any tobacco smoker could consider using the tool kit.

Asked to make a choice

Each card on the reverse gives the positives and negatives of each choice they make. If they are ready to make a decision, we facilitate it and then offer nicotine dependence counseling and pharmacotherapy if they chose yellow or green. If they are not ready to discuss, we offer the decision aid tool kit to be taken with them to their homes where they can discuss and it also offers the information on national and state quit lines and helpful websites.


It is a realistic portrayal of the smoking behavior, with advantages and disadvantages of each choice. Smokers really like it, since it is not judgmental and really appreciates that smoking itself may have some positives for the smoker. Just that acknowledgement creates a sense of trust and willingness to consider smoking cessation.


We have had children who had poorly controlled allergy and asthma symptoms and needed frequent hospitalizations. Now with tobacco control counseling and quit attempts from caregivers, these children are completely symptom free. The burden of disease and the amount of medication needed to control their symptoms has also dramatically decreased.

The parents never had a conversation about their smoking behavior in front of their child/children. Often, this is the first time the parent hears how their child feels about his/her parent’s smoking behavior. Hearing how they feel is very empowering for the individual to consider tobacco control.

About the Author: Avni Y. Joshi, MD, MSc, is an Assistant Professor of Pediatrics and Medicine and works in the areas of Pediatric and Adult Allergy/Immunology and the Cellular and Molecular Immunology Laboratory at the Mayo Clinic. Dr. Joshi’s focus is in how different people respond differently to tobacco smoke and the effects of secondhand smoke exposure, especially on children.