Addressing parental smoking in pediatrics and family practice: a national survey of parents.
BACKGROUND
Parental smoking has been associated with increased rates of sudden infant death syndrome, low birth weight, otitis media, asthma, and decreased lung growth. No prior parent surveys have assessed national rates of screening and counseling for parental tobacco use in the context of their child's visit to primary care.


OBJECTIVE
To assess and compare rates of pediatrician and family practitioner screening and counseling for parental smoking. Design/Methods. Data were collected by telephone survey of households from July to September 2001. The sample is weighted by race and gender based on 1999 US Census estimates to be representative of the US population.


RESULTS
Of 3566 eligible respondents contacted, 3002 (84%) completed surveys; 902 of those were parents who had a child seen by a pediatrician (62%) or family practitioner (38%) in the past year. About half of all parents who visited a pediatrician or family practitioner reported that they had been asked about household member smoking status (52% vs 48%). More parents who visited pediatricians had been asked if they had rules prohibiting smoking in the home than those who visited family practitioners (38% vs 29%). Of 190 (21%) parents who were smokers, fewer than half reported being counseled by either specialty about dangers of second-hand smoke (41% vs 33%) or risks of modeling smoking behavior (31% vs 28%). Similarly, fewer than half of parental smokers received advice to quit (36% vs 45%).


CONCLUSIONS
Overall rates of screening and counseling for parental smoking in pediatric and family practice are low. Despite some differences between specialties, significant opportunities exist to improve tobacco control activities in primary care settings that serve children.
MGH Center for Child and Adolescent Health Policy, Harvard Pediatric Health Services Research Program, Boston, Massachusetts 02114, USA. jwinickoff@partners.org
Jonathan P
JP
Winickoff
Robert C
RC
McMillen
Bronwen C
BC
Carroll
Jonathan D
JD
Klein
Nancy A
NA
Rigotti
Susanne E
SE
Tanski
Michael
M
Weitzman
D000328:Adult; D003376:Counseling; D005194:Family Practice; D006266:Health Education / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation; D014028:Tobacco Smoke Pollution / Q000517:prevention & control; D014481:United States
D014028:Tobacco Smoke Pollution