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The 13th World Conference on Tobacco OR Health
Building capacity for a tobacco-free world
July 12-15, 2006, Washington, DC, USA
Objective: Exposure to second-hand smoke (SHS) in homes has well-established health consequences for children; pediatricians and family practitioners are ideally positioned to reduce the exposure of children to smoke from parents and other family members. The objective of this study was to examine factors related to the these physicians' practices in advising parents, with a view to enhancing practice.
Methods: A detailed questionnaire on tobacco-related practice, practice environment, role perceptions, attitudes, and demographic factors was mailed to 1600 Canadian family physicians and pediatricians; the corrected response rate was 65 percent. Data were analyzed using a behavioral model including elements from the Health Belief Model, Social Cognitive Theory, and Diffusion of Innovation.
Results: A majority of physicians perceive that they have a major role in identifying parents who smoke when patients are children, but only about half report that they advise all or most parents to cut down or quit smoking. Less than one quarter give specific assistance in quitting. Pediatricians more likely to discuss the effects of SHS and to advise parents to cut down or quit; family practitioners are more likely to give specific help with quitting. Physicians who have tobacco-related continuing education and who practice in smoke-free communities are more likely to advise parents. Respiratory disease in children is a stimulus for advising parents to quit. A behavioral model helps in understanding physician practice and points to educational, system, and policy changes that facilitate physicians' counseling of parents who smoke when children are their patients.