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Addressing Parental Smoking at Pediatric Visits
Pediatricians are uniquely positioned to affect parental smoking and environmental tobacco smoke exposure of children due to the frequency of visits and the special physician-parent relationship in the context of the child’s healthcare. The objectives of this planning project were to evaluate current levels of tobacco cessation intervention in pediatric practice; assess the acceptability of a pediatric office-based focus on parental smoking with an economically and geographically heterogeneous sample of parents; refine exit interview, physician survey, and chart review instruments for use in community practice settings; determine feasible and effective means of incorporating a research component into community pediatric practices; develop collaborations for partnership in future studies; and work with a health plan to develop methods for encouraging pediatric provider adherence to the smoking cessation guideline. Outcome indicators were collected through parental exit interviews, chart reviews, pediatrician and parent questionnaires, physician and office staff interviews, and meetings with health plan representatives. Investigators found that despite the presence of written prompts, pediatricians are asking parents about smoking and documenting their responses at low rates overall. Although it appears that physicians have a sense of the prevalence of smoking in their practice, they are identifying only 1 of every 4 smokers at each visit, missing opportunities to intervene with the remaining 75% of smokers. The majority of parents, no matter their gender, educational level or racial group, don’t mind being asked about their smoking status and over half of smoking parents (58%) say that they would like tobacco cessation assistance in the pediatric setting. The study also found that pediatricians would be interested in participating in practice-based research if it provides some benefit/treatment for their patients and allows for flexibility to accommodate individual practice demands. Citation: Moss D, Cluss PA, Mesiano M, Kip KE. Accessing adult smokers in the pediatric setting: What do parents think? Nicotine & Tobacco Research 2006; 8(1): 67-75. For more information, contact: Patricia Cluss, Ph.D.
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