Tobacco use continues to be the most preventable cause of morbidity and mortality in the United States.1 Recently, the Institute of Medicine, the American College of Emergency Physicians, and the Public Health Service’s Clinical Practice Guideline Treating Tobacco Use and Dependence2 have stated that emergency departments (EDs) are an important venue in which to conduct cessation interventions.3,4 Tobacco screening and brief cessation interventions have been shown to be feasible in the ED setting and have the potential for resulting in a large public health impact.2,5–8 Adult smokers who visit the pediatric ED (PED) with their children have rates of smoking that exceed that of the general population,9–12 and their children are at increased risk of suffering from secondhand smoke exposure (SHSe)–related illnesses such as bronchiolitis, asthma, pneumonia, and ear infections.13,14 These parental smokers are concerned that their tobacco use may be harmful to their children, and they are interested in receiving cessation advice in the PED.11 However, the PED remains an underutilized and understudied venue in which to provide parental smoking interventions.15–19 If PED practitioners were to use each PED visit as a “teachable moment” to encourage and counsel parental smokers to quit, this may increase the parent’s subsequent quit attempts and may not only improve the health of the parent, but also improve the health of their child by decreasing SHSe-related visits and morbidity. Motivation to quit smoking is a key factor in determining cessation success. Motivation predicts participation in smoking cessation treatment, attempts to quit,20,21 and successful cessation.21 Research indicates that when a child has an SHSe-related illness such as asthma, parents may have increased motivation to quit compared with parents whose child does not have an SHSe-related illness.22,23 A recent study of parental smokers who had a child with asthma demonstrated that parents who believed that their child’s asthma symptoms would decrease if they quit smoking or who felt that their child’s asthma was not under good control were more motivated to quit smoking.24 Similarly, smokers who believe that they have a personal tobacco-related diagnosis or who have concerns about the effects of smoking on their health have a stronger motivation to quit compared with those without such concerns.3,20,25,26 Furthermore, studies in the adult ED setting have indicated that adult patients who anticipate greater health improvement with smoking cessation and those with greater perceived self-efficacy to quit are more motivated to quit.26 Given the increasing demands on resources in the PED, it is important to identify which factors are associated with motivation to quit so that interventions can be targeted to those smokers who are likely to succeed in their quitting attempts. Simply asking a smoker whether he/she is interested in quitting does not discriminate well those who are prepared to quit smoking and may actually make a serious attempt, as most smokers will express interest in quitting.26–28 The primary aim of this study was to determine if parental motivation to quit smoking was related to their perception of their personal or child’s smoking-related health risk or illness. Our hypothesis was that parental smokers who perceived that they, or their child, had a smoking-related health risk or illness would be more likely to be motivated to quit compared with those who did not. Our secondary aim was to determine demographics and smoking behavior characteristics associated with motivation to quit among parental smokers.