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Study finds children's doctors not asking parents about smoking
Missing opportunity to improve health of children and parents

BALTIMORE, May 6, 2002 -Parental smoking creates significant health risks for children; but are pediatricians and family practitioners doing anything about it? That's the question addressed by a study presented during the 2002 Pediatric Academic Societies' Meeting.

"Parental smoking is a huge issue in terms of costs for children. The list of health problems is tremendously long," says lead author Jonathan P. Winickoff, MD, MPH, of the Center for Child and Adolescent Health Policy at MassGeneral Hospital for Children. He lists sudden infant death syndrome, low birth weight, middle ear infections, asthma and decreased lung growth as some of the effects on children of parental smoking and also notes the negative economic impact of parents' spending a large percentage of their income on cigarettes.

Winickoff and his colleagues surveyed over 3,000 individuals by telephone, inquiring whether pediatricians or family practitioners asked them during regular visits whether household members smoked. Of those surveyed, 903 were parents whose children had been seen by pediatricians or family practitioners in the past year. About half of those reported that they had been asked about household member smoking status at their physician's office.

"This highlights that things need to improve," says Winickoff. "Here we have this wonderful opportunity to have a positive effect on the issue of smoking in the family, and there's not enough being done."

About a third of parents reported that their children's physicians inquired whether they had any rules prohibiting smoking in the home. Fewer than half of parental smokers reported being counseled about the dangers of second-hand smoke or the risks of setting an example for their children by smoking. "If you have rules about smoking, the child is less likely to grow up to be a smoker," argues Winickoff. "As physicians, we should ask and teach parents about the importance of smoking rules. If we don't ask, we can't teach."

Winickoff hopes that pediatricians and family practitioners will take better advantage of their unique position in order to help parents discourage their kids from smoking.

Winickoff's research was a collaboration with Robert C. McMillen, PhD, of the Social Science Research Center at Mississippi State University and Jonathan D. Klein, MD, MPH, and Michael Weitzman, MD, of the AAP Center for Child Health Research and Strong Children's Research Center at the University of Rochester. Winickoff's work is funded through the Agency for Healthcare Research and Quality.

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In 1994, the MGH joined with Brigham and Women's Hospital to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups and nonacute and home health services

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