Copyright © 2015 by the American Academy of Pediatrics. OBJECTIVES: Tobacco smoke exposure (TSE) increases the risk for respiratory-related disease and hospitalizations. The hypothesis of this study was that a brief intervention (which included a motivational video) provided to parents and caregivers during their child's hospitalization would be associated with improved knowledge and behavior changes that may reduce the child's TSE.METHODS: Parents and caregivers of children hospitalized for respiratory illnesses with TSE were recruited between June and December 2012. They completed a questionnaire to determine baseline knowledge regarding the health effects of smoke exposure. The intervention included a motivational video, written smoking cessation materials, and referral to the state quitline. The questionnaire was repeated after the intervention; telephone follow-up at 1 and 3 months included knowledge questions and assessed behavior changes. Paired t tests were used to compare preintervention and postintervention knowledge scores.RESULTS: A total of 167 parents/caregivers were enrolled. The mean preintervention knowledge score was high at 5.4 of 6, which improved for 60 parents/caregivers (36%, P < .001) after the intervention and was sustained at follow-up. Follow-up was obtained from 123 (74%) parents/caregivers, and 90% reported behavior changes to reduce TSE. There was a 13% reported quit rate among the 99 parents/caregivers who smoked (95% confidence interval: 7-21). Other behavior changes reported included initiating home and vehicle smoking bans, discussing reduction of the child's smoke exposure, and showing the video to others. Improvement in knowledge after this brief intervention was associated with reported initiation of home and vehicle smoking bans (P < .01).CONCLUSIONS: Parents and caregivers of smoke-exposed children hospitalized for respiratory illnesses had high baseline knowledge of the effects of TSE. A brief intervention that included a motivational video was associated with reported behavior changes in parents/caretakers that decreased second- and third-hand smoke. Improvement of knowledge was associated with institution of home and vehicle smoking bans.