Pediatricians' Practices and Attitudes about Environmental Tobacco Smoke and Parental Smoking

Objective: To assess pediatric resident and preceptor environmental tobacco smoke (ETS)-reduction practices and attitudes to inform the development of resident tobacco intervention training. Study design: Pediatricians in a teaching hospital anonymously completed a 65-item survey. Results: Residents' and preceptors' (n = 93) ETS actions were generally similar. Pediatricians inconsistently intervened across treatment settings and when treating different ETS-related illnesses (eg, 60% "always" assessed during asthma visits, 13% during otitis visits). Less than 50% "always" explained ETS risks to smoking parents and less than 33% "always" advised about creating smoke-free homes. Most pediatricians reported negative attitudes toward smoking parents; however, attitudes were not related to actions. Most frequently cited barriers to ETS action were lack of time and low confidence in effectiveness. Conclusion: Understanding barriers to ETS intervention could promote transdisciplinary (TD) training and intervention approaches that effectively promote pediatrician advice while offloading the time burden of intensive smoking intervention. ETS intervention training should foster pediatrician confidence and TD relationships with affiliated health professionals who could facilitate intervention, referral, and follow-up necessary to sustain smoking behavior change.