title: Black versus white differences in rates of addressing parental tobacco use in the pediatric setting.
abstract: OBJECTIVE
  To examine racial differences in rates of screening parents for cigarette smoking during pediatric outpatient visits and to determine if a parental tobacco control intervention mitigates racial variation in whether cigarette smoking is addressed.
  
  
  METHODS
  As part of the Clinical Effort Against Secondhand Smoke Exposure (CEASE) randomized controlled trial, exit interviews were conducted with parents at 10 control and 10 intervention pediatric practices nationally. Parents were asked to report if during the visit did anyone ask if they smoke cigarettes. A generalized linear mixed model was used to estimate the effect of black vs white race on asking parents about cigarette smoking.
  
  
  RESULTS
  Among 17,692 parents screened at the exit interview, the proportion of black parents who were current smokers (16%) was lower than the proportion of white parents who smoked (20%) (P < .001). In control group practices, black parents were more likely to be asked (adjusted risk ratio 1.23; 95% confidence interval 1.08, 1.40) about cigarette smoking by pediatricians than whites. In intervention group practices both black and white parents were more likely to be asked about smoking than those in control practices and there was no significant difference between black and white parents in the likelihood of being asked (adjusted risk ratio 1.01; 95% confidence interval 0.93, 1.09).
  
  
  CONCLUSIONS
  Although a smaller proportion of black parents in control practices smoked than white, black parents were more likely to be asked by pediatricians about smoking. The CEASE intervention was associated with higher levels of screening for smoking for both black and white parents.
authors.affiliation: Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass.
authors.forename: Janelle
authors.initials: J
authors.lastname: Dempsey
authors.affiliation: General Medicine Division, Massachusetts General Hospital, Boston, Mass.
authors.forename: Susan
authors.initials: S
authors.lastname: Regan
authors.affiliation: Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass.
authors.forename: Jeremy E
authors.initials: JE
authors.lastname: Drehmer
authors.affiliation: Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, Ill.
authors.forename: Stacia
authors.initials: S
authors.lastname: Finch
authors.affiliation: Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass.
authors.forename: Bethany
authors.initials: B
authors.lastname: Hipple
authors.affiliation: AAP Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Ill.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Klein
authors.affiliation: Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass.
authors.forename: Sybil
authors.initials: S
authors.lastname: Murphy
authors.affiliation: Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass.
authors.forename: Emara
authors.initials: E
authors.lastname: Nabi-Burza
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, NY.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ossip
authors.affiliation: UCLA West Los Angeles Office, Los Angeles, Calif.
authors.forename: Heide
authors.initials: H
authors.lastname: Woo
authors.affiliation: Center for Child and Adolescent Health Research and Policy, and Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Mass; General Medicine Division, Massachusetts General Hospital, Boston, Mass; Department of Public Health Sciences, University of Rochester, Rochester, NY. Electronic address: jwinickoff@mgh.harvard.edu.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Winickoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010290:Parents; D010372:Pediatrics / Q000379:methods*; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D064424:Tobacco Use; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: pediatrics; racial differences; smoking cessation; tobacco control; tobacco smoke