RESEARCH PAPER
Physician advice on avoiding secondhand smoke exposure and referrals for smoking cessation services
Judy Kruger 1  
,  
Steve Babb 1
,  
 
 
More details
Hide details
1
Centers for Disease Control and Prevention, Office on Smoking and Health, Atlanta, USA
CORRESPONDING AUTHOR
Judy Kruger   

Centers for Disease Control and Prevention, Office on Smoking and Health, 4770 Buford Highway, M/S-K-50, Atlanta, GA 30341, USA
Publish date: 2012-07-02
 
Tobacco Induced Diseases 2012;10(July):10
KEYWORDS
ABSTRACT
Background:
Secondhand smoke (SHS) exposure causes premature death and disease. Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from SHS exposure, and also contributes to helping smokers quit smoking. Primary health care providers can play an important role in advising nonsmoking patients to avoid SHS exposure, cautioning current smokers against exposing others to SHS, and referring tobacco users to cessation programs.

Methods:
The purpose of this paper is to examine primary care provider (obstetricians/gynecologists, pediatricians, and general practitioners) advice regarding SHS exposure and referral to cessation programs. Using data from the 2008 DocStyles survey (n = 1,454), we calculated the prevalence and adjusted odds ratios for offering patients advice regarding SHS exposure and referring adults who smoked or used other tobacco products to a cessation program.

Results:
The current study found that among a convenience sample of primary care providers, 94.9% encouraged parents to take steps to protect children from SHS exposure, 86.1% encouraged smokers to make their homes and cars smoke-free, and 77.4% encouraged nonsmokers to avoid SHS exposure. Approximately 44.0% of primary care providers usually or always referred patients who smoked or used tobacco products to cessation programs such as a quitline, a group cessation class, or one-on-one counseling.

Conclusions:
Findings from a convenience sample of primary care providers who participated in a web-based survey, suggests that many primary care providers are advising parents to protect children from SHS exposure, encouraging patients who smoke to maintain smoke-free homes and cars, and advising smokers on ways to avoid exposing others to SHS. Healthcare providers are encouraged to advise patients to avoid SHS exposure and to refer patients who use tobacco products to cessation services.

 
REFERENCES (23)
1.
US Department of Health and Human Services: The Health Consequences of Involuntary Exposure to Tobacco Smoke: a Report of the Surgeon General. 2006, Centers for Disease Control and Prevention, Atlanta, [http://www.cdc.gov/tobacco/dat...], (Accessed 2012, April26).
 
2.
World Health Organization: WHO Report on the Global Tobacco Epidemic, 2008—the MPOWER Package. 2008, World Health Organization, Geneva.
 
3.
International Agency for Research on Cancer: Evaluating the Effectiveness of Smoke-Free Policies. IARC Handbooks of Cancer Prevention, Tobacco Control Volume 13. 2009, World Health Organization Press, Lyon, [http://www.iarc.fr/en/publicat...], (Accessed 2012, April 26).
 
4.
World Health Organization: WHO Report on the Global Tobacco Epidemic, 2009. Implementing Smoke-Free Environments. 2009, Geneva: World Health Organization,, [www.who.int/tobacco/mpower/en/], (Accessed 2012, April 26).
 
5.
Institute of Medicine: Secondhand Smoke Exposure and Cardiovascular Effects. Making Sense of the Evidence. 2010, National Academies Press, Washington, [http://www.cdc.gov/tobacco/bas...](Accessed 2012, April 26).
 
6.
Rigotti NA: Integrating comprehensive tobacco treatment into the evolving US health care system. Arch Intern Med. 2011, 171 (1): 53-55. 10.1001/archinternmed.2010.491.
 
7.
National Committee for Quality Assurance: The State of Health Care Quality. National Committee for Quality Assurance. 2009, , Washington, [http://www.ncqa.org/Portals/0/...], (Accessed 2012, April 26).
 
8.
Centers for Disease Control and Prevention: State Medicaid coverage for tobacco-dependence treatments—United States, 2009. MMWR. 2010, 59 (41): 1340-1343.
 
9.
Fiore MC, Jaen CR, Baker TB, et al: Clinical Practice Guideline. Treating Tobacco use and Dependence: 2008 Update. 2008, US Department of Health and Human Services, Public Health Service. Rockville, Rockville, http://www.ncbi.nlm.nih.gov/bo..., (Accessed 2012, April 26).
 
10.
Task Force on Community Preventive Services: The Guide to Community Preventive Services: What Works to Promote Health?. Edited by: Stephanie Zaza, Briss Peter A, Harris Kate W. 2005, Oxford University Press, New York, http://www.thecommunityguide.o..., (Accessed 2012, April 26).
 
11.
Agency for Health Care Policy and Research: Smoking Cessation, Clinical Practice Guideline Number 18. JAMA. 1996, 275: 1270-1280.
 
12.
Novelli P: DocStyles 2008: METHODS. 2008, Washington, DC.
 
13.
American Academy of Family Physicians: Tobacco use, prevention and cessation [policy statement]. 2005, Leawood: American Academy of Family Physicians,, [www.aafp.org/online/en/home/po...], (Accessed 2012, April 26).
 
14.
US Preventive Services Task Force: Counseling to prevent tobacco use and tobacco-caused diseases. 2003, Rockville: US Preventive Services Task Force,, [www.uspreventiveservicestaskfo...], (Accessed 2012, April 26).
 
15.
Centers for Disease Control and Prevention: State-specific secondhand smoke exposure and current cigarette smoking among adults—United States, 2008. MMWR. 2009, 58 (44): 1232-1235.
 
16.
Centers for Disease Control and Prevention: State Smoking Restrictions for Private-Sector Worksites, Restaurants, and Bars—United States, 2004 and 2007. MMWR. 2008, 57 (20): 549-552.
 
17.
Winickoff JP, Park ER, Hipple BJ, Berkowitz A, Vieira C, Friebely J, Healey EA, Rigotti NA: Clinical effort against secondhand smoke exposure (CEASE): development of framework and intervention. Pediatrics. 2008, 122 (2): 363-375. 10.1542/peds.2008-0478.
 
18.
Williams GC, Williams SA, Korn RJ: Secondhand smoke (SHS) deserves more than secondhand attention: Modifying the 5 As model to include counseling to eliminate exposure. Families, Sys Health. 2005, 23 (3): 266-277.
 
19.
Centers for Disease Control and Prevention: State Tobacco Activities Tracking and Evaluation (STATE) System. 2009, Atlanta: US Department of Health and Human Services,, [www.cdc.gov/tobacco/statesyste...], (Accessed 2012, April 26).
 
20.
Samet JM: Could secondhand smoke exposure harm the mental health of children?. Arch Pedia Adol Med. 2011, 165 (4): 370-372. 10.1001/archpediatrics.2011.21.
 
21.
Schnoll RA, Rukstalis M, Wileyto P, Shields AE: Smoking cessation treatment by primary care physicians: An update and call for training. Am J Prev Med. 2006, 31 (3): 233-239. 10.1016/j.amepre.2006.05.001.
 
22.
Tong EK, Strouse R, Hall J, Kovac M, Schroeder SA: National survey of U.S. health professionals’ smoking prevalence, cessation practices, and beliefs. Nicotine Tob Res. 2010, 12 (7): 724-733. 10.1093/ntr/ntq071.
 
23.
Cape J, Parham A: Relationship between practice counseling and referral to outpatient psychiatry and clinical psychology. Br J Gen Pract. 1998, 48 (433): 1477-1480.
 
 
CITATIONS (9):
1.
Brief Educational Intervention to Improve Medical Student Competence in Managing Patients Exposed to Secondhand Smoke
Lisa J. Merlo, Jill A. Sutton, Mark S. Gold
Substance Abuse
 
2.
Dealing with tobacco use and dependence within primary health care: time for action
Constantine Ilias Vardavas, Emmanouil K Symvoulakis, Christos Lionis
Tobacco Induced Diseases
 
3.
Physician screening and recommendations on secondhand smoke in chronic rhinosinusitis patients
Carrie L. Nieman, Ana Navas-Acien, Sandra Y. Lin, Douglas D. Reh
International Forum of Allergy & Rhinology
 
4.
A Scoping Review of Maternal and Child Health Clinicians Attitudes, Beliefs, Practice, Training and Perceived Self-Competence in Environmental Health
Lamin Massaquoi, Nancy Edwards
International Journal of Environmental Research and Public Health
 
5.
The Secondhand Smoke Exposure Scale (SHSES): A hair nicotine validated tool for assessing exposure to secondhand smoke among elderly adults in primary care
Constantine Vardavas, Israel Agaku, Filippos Filippidis, Antonis Kousoulis, Charis Girvalaki, Emmanouil Symvoulakis, Manolis Tzatzarakis, Aristidis Tsatsakis, Panagiotis Behrakis, Christos Lionis
Tobacco Prevention & Cessation
 
6.
Primary Care Healthcare Professionals’ Knowledge, Attitudes, and Practices Towards Promoting the Reduction of Children’s Secondhand Smoke Exposure: A Mixed-Methods Review and Synthesis
Jaidev Kaur, Amanda Farley, Kate Jolly, Laura L Jones
Nicotine & Tobacco Research
 
7.
Allergic diseases, smoking, and environmental exposure among university students in Lebanon
Souheil Hallit, Tarek Bou Assi, Rabih Hallit, Pascale Salameh
Journal of Asthma
 
8.
Assessing the Delivery of Cessation Services to Smokers in Urban, Safety-Net Clinics
Martin C. Mahoney, Annamaria Masucci Twarozek, Frances Saad-Harfouche, Christy Widman, Deborah O. Erwin, Willie Underwood, Chester H. Fox
Journal of Community Health
 
9.
General Practitioners and Dentists: A Call for Action Against Tobacco
Silvano Gallus, Alessandra Lugo, Silvio Garattini, Roberta Pacifici, Luisa Mastrobattista, Giuseppe Marzo, Luigi Paglia
Nicotine & Tobacco Research
 
eISSN:1617-9625