Hymowitz Norman, Schwab Joseph, Haddock Christopher keith, Pyle Sara, Moore Glenisha, Meshberg Sarah
Department of Psychiatry, UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA.
Prev Med. 2005 Jul;41(1):334-41. doi: 10.1016/j.ypmed.2004.11.019.
Pediatricians have an important and unique role to play in the anti-tobacco arena. They may prevent relapse to smoking in women who stopped smoking during pregnancy, encourage parents to protect infants and young children from environmental tobacco smoke (ETS), prevent the onset of smoking in children and adolescents, and help patients and parents who smoke or use other forms of tobacco to quit. Unfortunately, few pediatricians intervene on tobacco use or ETS, and few pediatric residency training programs prepare residents to address tobacco. The Pediatric Residency Training on Tobacco Project is a 4-year randomized prospective study of the effectiveness of training pediatric residents to intervene on tobacco in patients and parents. In this paper, we present findings from the Baseline Parent/Guardian Tobacco Survey.
Fifteen pediatric residency training programs participated in the Pediatric Residency Training on Tobacco Project, and they were assigned randomly to special and standard training conditions. The Baseline Parent/Guardian Tobacco Survey was administered to 1770 participants, a minimum of 100 from each site. The Parent/Guardian Survey was designed to describe the population under study. It addressed demographic information, family tobacco use, rules concerning smoking in the home and elsewhere, smoking behavior and beliefs, and parent/guardian reports of resident intervention on tobacco. Data analyses described the population served by Continuity Clinics associated with the pediatric residency training programs and determined the degree to which residents addressed tobacco in parents/guardians.
The parents/guardians were primarily low-income African American and Hispanic females. Approximately 20% reported that they smoked cigarettes, and about 60% prohibited smoking in their home. Seventy percent of the parents reported that the resident asked about cigarette smoking, and about half indicated that the resident talked with them about ETS. However, only about 10% of the smokers stated that the doctor offered to help them stop smoking, and just 25% of all parents/guardians indicated that the doctor offered to help them stop exposing their children to ETS in the home or elsewhere.
Parents of children brought to Continuity Clinic may benefit from advice and assistance on quitting cigarette smoking and protecting their children from ETS. While pediatric residents offer advice and encouragement, few provide the assistance parents require. These findings underscore the importance of training pediatric residents to address tobacco with the parents/guardians of the patients they serve.
儿科医生在反烟草领域发挥着重要且独特的作用。他们可以防止孕期戒烟的女性复吸，鼓励家长保护婴幼儿免受环境烟草烟雾（ETS）的危害，预防儿童和青少年开始吸烟，并帮助吸烟或使用其他烟草形式的患者及家长戒烟。不幸的是，很少有儿科医生对烟草使用或ETS进行干预，而且很少有儿科住院医师培训项目让住院医师准备好应对烟草问题。儿科住院医师烟草培训项目是一项为期4年的随机前瞻性研究，旨在研究培训儿科住院医师对患者及其家长的烟草使用进行干预的效果。在本文中，我们展示了基线家长/监护人烟草调查的结果。
15个儿科住院医师培训项目参与了儿科住院医师烟草培训项目，它们被随机分配到特殊培训和标准培训条件下。对1770名参与者进行了基线家长/监护人烟草调查，每个地点至少100人。家长/监护人调查旨在描述所研究的人群。它涉及人口统计学信息、家庭烟草使用情况、家庭及其他场所吸烟的规定、吸烟行为和观念，以及家长/监护人关于住院医师对烟草干预的报告。数据分析描述了与儿科住院医师培训项目相关的连续性诊所所服务的人群，并确定了住院医师在家长/监护人中处理烟草问题的程度。
家长/监护人主要是低收入的非裔美国人和西班牙裔女性。约20%的人报告自己吸烟，约60%的人禁止在家中吸烟。70%的家长报告住院医师询问过吸烟情况，约一半的家长表示住院医师与他们谈论过ETS。然而，只有约10%的吸烟者表示医生主动提出帮助他们戒烟，所有家长/监护人中只有25%表示医生主动提出帮助他们停止在家中或其他地方让孩子接触ETS。
带到连续性诊所的儿童的家长可能会从关于戒烟和保护孩子免受ETS危害的建议和帮助中受益。虽然儿科住院医师提供了建议和鼓励，但很少有人提供家长所需的帮助。这些发现强调了培训儿科住院医师与他们所服务患者的家长/监护人处理烟草问题的重要性。
