AAP RCE - SECONDHAND SMOKE AND TOBACCO
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AAP RCE - SECONDHAND SMOKE AND TOBACCO
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Counseling Parents AAP RCE - SECONDHAND SMOKE AND TOBACCO
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AAP RCE - SECONDHAND SMOKE AND TOBACCO
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Counseling Parents about Smoking Cessation
Father carrying his son on his shoulders.
Why Counsel
  • Parental smoking is the main source of children’s secondhand smoke exposure.
  • When parents quit smoking adolescents are less likely to start.
  • Pediatric clinicians have direct contact with roughly 25% of the nation’s smokers through child health visits.
  • Parental counseling by the child’s physician increases rates of parents’ attempts to quit.
  • Most parents see their child’s provider more frequently than their own, with an average of 10 visits in the first 2 years of a child’s life.
  • While many children are covered by Medicaid, their parents may be uninsured, so pediatric clinicians may be their only available source of counseling.

When to Counsel
  • If smoking, counsel adolescents and parents to quit tobacco use.
  • If smoking, counsel parents to prevent and reduce children's exposure to secondhand smoke.
  • If smoking/not smoking assist new parents in their efforts to avoid relapse following pregnancy.
  • If not smoking counsel pre-adolescents and adolescents to prevent initiation of tobacco use.

How to Counsel
  • Brief counseling, delivered in as little as 3 minutes, can be effective.
  • Focus on the child as a primary beneficiary of smoking cessation.

Counseling Techniques

New Paradigm for Physician Intervention: 2 A's + R
Physicians can also help patients who smoke to quit through an effective 30-second intervention, 2 A's + R (Ask, Advise, Refer): physicians Ask patients if they smoke, Advise them to quit, and Refer them to a Quitline 1-800-QUIT NOW or to community/internet quit resources.


Five A’s
The Agency for Healthcare Research and Quality has developed Five Major Steps to Intervention (the "5 A's") for clinicians to provide counseling to tobacco users who want to quit.

Motivational Interviewing
Motivational interviewing is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. The following website link provides more information on motivational interviewing. It includes details about this approach, other links, training resources, reprints information and current research.

AAP RCE - SECONDHAND SMOKE AND TOBACCO
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