Increasing physician screening and counseling for passive smoking.
BACKGROUND
The adverse health effects of passive smoking on children, including increased respiratory tract illnesses and otitis media, are well documented. A child's visit to a physician for these illnesses represents a "teachable moment" to screen for household smokers and to counsel parents regarding the health effects of passive smoking. Whether physicians are performing these activities in their offices is unknown. We hypothesized that screening and counseling by physicians with regard to passive smoking would be low in this setting and that these activities could be increased by a simple, two-part intervention.


METHODS
We used chart audits and postvisit parental surveys to assess the preintervention and postintervention screening and counseling activities of physicians with regard to passive smoking. The two-part intervention consisted of a 2-hour educational seminar for the physicians and a passive smoking chart reminder and documentation system.


RESULTS
In comparing the preintervention with the post-intervention parental surveys, there were increases in the passive smoking screening (17% vs 32%, P = .03) and counseling (19% vs 46%, P = .03) activities of physicians. Chart documentation of these activities, however, showed very little change regarding screening (2% vs 6%, P = .19) or counseling (4% vs 6%, P = .64).


CONCLUSIONS
These results indicate initially low rates of passive smoking screening and counseling of parents by physicians during acute illness visits of their children. These data also indicate that a simple two-part intervention was very useful in increasing passive smoking screening and counseling activities by physicians in this setting.
Narce-Valente
S
S
Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson 85719.
Kligman
E W
EW
D002675:Child, Preschool; D003625:Data Collection / Q000379:methods; D003627:Data Interpretation, Statistical; D005194:Family Practice; D006266:Health Education; D006801:Humans; D007223:Infant; D010290:Parents; D011322:Primary Prevention; D012141:Respiratory Tract Infections / Q000209:etiology* / Q000517:prevention & control; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000517:prevention & control*
D014028:Tobacco Smoke Pollution