Secondhand smoke (SHS) deserves more than secondhand attention: Modifying the 5As model to include counseling to eliminate exposure.

Williams, Geoffrey

doi:10.1037/1091-7527.23.3.266

Cited by 14 publications

(17 citation statements)

References 34 publications

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“…These participants also had access to regular medical care. Nevertheless, studies on this population can inform rural primary care physicians who have the opportunity to address home smoking restrictions during regular clinic visits or during the diagnosis of a smoking-related illness (Williams, Williams, & Korn, 2005). Physicians also may assess for predictors of restrictions among their patients, such as level of nicotine dependence and the presence of children or of nonsmoking partners, to better understand the patient's health risk profile and the effectiveness of efforts to incorporate home smoking restrictions.…”

Section: Discussionmentioning

confidence: 97%

Correlates of home smoking restrictions among rural smokers

Berg

Cox

Nazir

et al. 2006

Nicotine & Tobacco Research

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The prevalence of smoking is greater and smoking restrictions are less common in rural areas in comparison to urban areas. Consequently, rural smokers and their families are at increased risk for adverse health consequences from smoking. The presence of home smoking restrictions (i.e., limiting or banning cigarette smoking in the home) can be a mediator for smoking cessation and can reduce health risks for those who live with smokers. The purpose of the present study was to identify correlates of home smoking restrictions among rural smokers. We surveyed 472 smokers from 40 rural Kansas primary care practices who were enrolled in a smoking cessation intervention study. We assessed the prevalence of home smoking restrictions and examined the relationship between such restrictions, demographic variables, comorbid diagnoses, and psychosocial measures of smoking abstinence self-efficacy and motivation to quit. Complete home smoking restrictions were found among 25.4% of rural smokers with an additional 28.3% reporting some restrictions. Restrictions were associated with younger age, higher controlled motivation to quit (i.e., motivation from external pressure), the presence of children under age 6 years living in the home, fewer friends who smoke, and a partner who does not smoke. Smokers with a comorbid diagnosis of high cholesterol, chronic lung disease, or heart disease were less likely to have restrictions. Most smokers in rural primary care practices do not have home smoking restrictions, particularly those without children or a nonsmoking partner and those with significant risk factors for smoking-related illnesses. These patients may be critical targets for broaching issues of home smoking restrictions.

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Section: Discussionmentioning

confidence: 97%

Correlates of home smoking restrictions among rural smokers

Berg

Cox

Nazir

et al. 2006

Nicotine & Tobacco Research

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“…But there are also studies, which indicate that tobacco control policies influence individual perceptions even when their own behaviour is not regulated (Biener et al, 2010;Chou et al, 2013;Levy & Friend, 2003). It might therefore take some time before these changed perceptions, which increase motivation to quit (Williams et al, 2005;Chou et al, 2013), lead to a behavioural shift.…”

Section: Discussionmentioning

confidence: 94%

“…In fact, the literature indicates that hospital tobacco control policies increase staff and patient satisfaction, facilitate the reduction of daily cigarettes, increase motivation to quit and the likelihood of cessation (Gadomski, Stayton, Krupa, & Jenkins, 2010;Martinez, Garcia, Mendez, Peris, & Fernandez, 2008;Donath, Metz, & Kröger, 2005;Nakagawa, Tanaka, Aoki, & Seo, 2004;Longo et al, 1998). Implementation of smoke-free policies is associated with increased cessation attempts and successful long-term cessation among affected smokers (Williams et al, 2005;Moskowitz, Lin, & Hudes, 2000;Bauer et al, 2005;Stephen, Pederson, Koval, & Macnab, 2001). Smoking restrictions may also change social norms concerning the acceptability of smoking in a community.…”

Section: Introductionmentioning

confidence: 95%

Influence of individual characteristics and tobacco control policy on smoking cessation in patients in German somatic and psychosomatic rehabilitation

Birk

Piontek

Kröger

et al. 2014

Drugs: Education, Prevention and Policy

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Aims: The goal of this study was to analyse the influence of individual characteristics and tobacco control policies on smoking status and tobacco consumption amongst patients in (psycho-) somatic rehabilitation centres. Methods: A multicentre field study with pre-post-follow up design was carried out in 19 German rehabilitation centres. Each trainer of the cessation programme answered a tobacco control policy questionnaire (N ¼ 19). Data from 367 patients were assessed at admission and discharge; data from 262 patients were collected at telephone follow-up six months after intervention. Multilevel analyses (HLM) were applied to identify the predictive value of individual and tobacco control policy characteristics on smoking behaviour directly after the intervention and six months later. Findings: Enforcement of smoking restrictions was a significant positive predictor for cessation rate at discharge and reduction rate at follow-up. Significant individual predictors for quitting include education, motivation and self-efficacy. Reduction rates were influenced by individual characteristics like motivation, self-efficacy, tobacco dependence and smoking rate at admission. Conclusions: Evidence-based measures should be applied to the individual to raise cessation and reduction. Additionally, implementing and enforcing smoking restrictions is another effective method to improve the health of the public.

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“…Evidence in the literature supports a provider-led, systematic approach that incorporates the "5 A' s" behavioral change model. 5,[15][16][17][18] In a comprehensive systematic review, Pbert et al found that any system that addresses SHS can have a positive impact on influencing the behaviors of smokers. 10 We simplified the "5 A' s" to 3, and compared with previous studies 7,8 our study showed higher rates of AAR practices: 80% Ask, 90% Advise to take 1 step outside, and 10% to 50% Refer by faxing a referral form to QuitLine.…”

Section: Discussionmentioning

confidence: 99%

The ONE Step Initiative: Quality Improvement in a Pediatric Clinic for Secondhand Smoke Reduction

Bunik¹,

Cavanaugh²,

Herrick

et al. 2013

Pediatrics

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BACKGROUND AND OBJECTIVE: Although comprehensive smoking counseling to limit secondhand smoke (SHS) is widely endorsed, it is often not done. Published evaluations of brief and practical systems that improve screening and counseling to reduce SHS are limited. Our objective was to determine if a quality improvement activity around smoking counseling leads to changes in (1) medical assistant and pediatric provider assessment of smoking history and (2) smoking or other behaviors affecting children' s SHS exposure. METHODS:In a large urban teaching clinic we assessed the ONE Step intervention, which included the following: (1) "Ask" (medical assistant asking whether caregivers smoke); (2) "Advise" (providers advising smoking outside and quitting if ready); (3) "Refer" (providers referring to the Colorado telephone QuitLine); and (4) electronic medical record prompts and required documentation regarding smoking. Medical assistant and provider assessments of smoking were evaluated with a chart review by using a pre-/posttest design. Caregiver behavior change was evaluated with a time-series survey that included assessment at baseline and follow-up via telephone at 6 and 12 months from study entry. RESULTS: ONEStep was associated with a statistically significant increase in Ask, Advise, and Refer documentation. Caregiver surveys showed that 97% found discussions of SHS with providers acceptable. Six-and 12-month follow-ups, respectively, showed that 14% and 13% of smokers reported quitting and that 63% and 70% of current smokers reported reduced SHS exposure. CONCLUSIONS: ONEStep was feasible to deliver in a busy outpatient setting, acceptable to families, and appears to have resulted in decreased exposure to SHS in our pediatric population. Pediatrics 2013;132:e502-e511 AUTHORS:

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Secondhand smoke (SHS) deserves more than secondhand attention: Modifying the 5As model to include counseling to eliminate exposure.

Cited by 14 publications

References 34 publications

Correlates of home smoking restrictions among rural smokers

Correlates of home smoking restrictions among rural smokers

Influence of individual characteristics and tobacco control policy on smoking cessation in patients in German somatic and psychosomatic rehabilitation

The ONE Step Initiative: Quality Improvement in a Pediatric Clinic for Secondhand Smoke Reduction

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