title: Routine screening of hospital patients for secondhand tobacco smoke exposure: a feasibility study.
abstract: OBJECTIVE
  Secondhand tobacco smoke (SHS) exposure causes over 40,000 deaths per year, but healthcare systems rarely address this risk factor. In September 2012, Massachusetts General Hospital initiated routine inpatient screening for SHS exposure by adding a question to the nurses' computerized admission assessment form ("Is smoking allowed in your home or car?"). We measured the implementation of this screening question over 1year.
  
  
  METHODS
  Multivariable analysis of hospital records of adult and pediatric admissions (N=35,701) from September 1, 2012 to August 31, 2013, to assess screening question completion and identify characteristics of nonsmokers who may be exposed to SHS.
  
  
  RESULTS
  Nurses entered "Yes" or "No" to the screening question for 91% of 34,295 adult admissions and 86% of 1406 pediatric admissions. Among nonsmokers, smoking in the home or car was allowed for 3% of adult admissions and 4% of pediatric admissions. Adults admitted for psychiatric diagnoses, children admitted for asthma, and patients with Medicaid insurance had higher odds of exposure to SHS in their home or car.
  
  
  CONCLUSIONS
  Routine screening of SHS among hospitalized patients by nurses is feasible. Doing so offers hospitals an opportunity to intervene and to promote smoke-free policies in patients' homes and cars.
authors.affiliation: Division of General Internal Medicine Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA. Electronic address: gkruse@mgh.harvard.edu.
authors.forename: Gina Rae
authors.initials: GR
authors.lastname: Kruse
authors.affiliation: Division of General Internal Medicine Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001336:Automobiles; D057286:Electronic Health Records; D005240:Feasibility Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006761:Hospitals; D006801:Humans; D016015:Logistic Models; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009726:Nurses; D010343:Patient Admission; D012111:Residence Characteristics; D012307:Risk Factors; D061845:Smoke-Free Policy; D012907:Smoking; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000032:analysis*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Electronic health records; Secondhand tobacco smoke exposure; Smoke-free homes