Triple tobacco screen: opportunity to help families become smokefree.
BACKGROUND
American Academy of Pediatrics policy recommends that pediatricians document environmental tobacco smoke (ETS) exposure of a child at every visit. The extent to which pediatricians adhere to this policy, however, is unknown.


OBJECTIVE
The goal of the study was to examine the extent to which pediatricians screen parents for tobacco use and home- and car-related smoking rules. Further, the potential association between factors associated with pediatrician inquiry into parental tobacco use and rules is examined.


METHODS
Post-visit exit interviews were conducted in ten pediatric practices between June 2009 and March 2011 with parents whose children had been seen by a healthcare provider. Parents were considered to have been given the "triple tobacco screen" if they reported being asked by a pediatric healthcare provider about their smoking behavior, smokefree home rules, and smokefree car rules. Bivariate analysis and multivariable logistic regression was done to explore factors associated with parents being given any component of the triple tobacco screening. Data were analyzed between March 2012 and February 2013.


RESULTS
Of 9145 parents interviewed, 20% of the parents reported being asked at least one question from the triple tobacco screen, and only 9% reported being asked all three questions. Overall, 17% of parents reported being asked about their smoking status, 16% about smokefree home rules, and 11% about smokefree car rules. Few smoking parents (23%) and fewer nonsmoking parents (19%) were screened about their tobacco use and behavior.


CONCLUSIONS
Pediatricians infrequently addressed ETS exposure of children among parents who do and do not smoke. Substantial missed opportunities may exist to counsel smokers and reduce ETS exposure of children in the most common exposure locations-the home and car.
Center for Child and Adolescent Health Research and Policy, Massachusetts General Hospital for Children, Boston, Massachusetts. Electronic address: emaranburza@gmail.com.
Emara
E
Nabi-Burza
Jonathan P
JP
Winickoff
Stacia
S
Finch
Susan
S
Regan
D000328:Adult; D001336:Automobiles; D002648:Child; D003625:Data Collection; D004282:Documentation; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010290:Parents; D010372:Pediatrics / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D061845:Smoke-Free Policy; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000032:analysis*
D014028:Tobacco Smoke Pollution