title: A snapshot of tobacco-related messages relayed in pediatric offices in Delaware.
abstract: OBJECTIVE
  Much research exists demonstrating that pediatricians should counsel patients and families about tobacco. However, few data are available about tobacco-related messages relayed in pediatric offices. Since an anti-tobacco office environment can be a strong component of an active tobacco prevention program, we evaluated pediatric offices in Delaware to characterize tobacco-related messages.
  
  
  METHODS
  A convenience sample of 32 of 63 (51%) pediatric offices in Delaware was directly evaluated for the presence of tobacco-related messages. Fifty-five of 63 (87%) pediatric practices in Delaware were contacted by telephone to inquire about the presence of a tobacco coordinator.
  
  
  RESULTS
  The 32 practices represented 71 physicians, were located in all three counties throughout the state, and were urban and non-urban in setting. The same investigator evaluated practices in a single site visit. All were located in smoke-free buildings. At one office, people were seen smoking outside; however, the presence of discarded cigarettes was much more common. Thirteen practices (41%) employed smokers, most of whom smoked outside during work hours. Twenty-one of 28 practices (75%) had waiting room magazines containing tobacco advertisements. Fifteen practices (47%) offered anti-tobacco literature while six practices (19%) displayed visual media, none exclusively addressing tobacco. Nine practices (28%) use chart flags to identify smokers. None of 55 pediatric practices in Delaware contacted by telephone identified an office tobacco prevention coordinator.
  
  
  CONCLUSIONS
  Our data indicate that, in Delaware, the pediatric offices we visited overall convey a limited message about tobacco and could strengthen tobacco prevention strategies. Research measuring the impact of office-based anti-tobacco messages is needed. If these messages are effective in preventing tobacco use, practitioners can supplement active counseling with indirect interventions that require minimal maintenance once established and that place no additional demands on their time.
authors.affiliation: Tobacco Prevention Program, A.I. duPont Hospital for Children, Wilmington, Delaware, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Feinson
authors.forename: Erin
authors.initials: E
authors.lastname: Raughley
authors.forename: Christine D
authors.initials: CD
authors.lastname: Chang
authors.forename: Aaron
authors.initials: A
authors.lastname: Chidekel
mesh_terms: D003691:Delaware; D006801:Humans; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data*; D010819:Physician's Role; D010824:Physicians' Offices / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011634:Public Health / Q000193:education; D000074606:Smoking Prevention; D014029:Tobacco Use Disorder / Q000517:prevention & control*