Tobacco Use: A Pediatric Disease

Abstract

Tobacco use and secondhand tobacco-smoke (SHS) exposure are major national and international health concerns. Pediatricians and other clinicians who care for children are uniquely positioned to assist patients and families with tobacco-use prevention and treatment. Understanding the nature and extent of tobacco use and SHS exposure is an essential first step toward the goal of eliminating tobacco use and its consequences in the pediatric population. The next steps include counseling patients and family members to avoid SHS exposures or cease tobacco use; advocacy for policies that protect children from SHS exposure; and elimination of tobacco use in the media, public places, and homes. Three overarching principles of this policy can be identified: (1) there is no safe way to use tobacco; (2) there is no safe level or duration of exposure to SHS; and (3) the financial and political power of individuals, organizations, and government should be used to support tobacco control. Pediatricians are advised not to smoke or use tobacco; to make their homes, cars, and workplaces tobacco free; to consider tobacco control when making personal and professional decisions; to support and advocate for comprehensive tobacco control; and to advise parents and patients not to start using tobacco or to quit if they are already using tobacco. Prohibiting both tobacco advertising and the use of tobacco products in the media is recommended. Recommendations for eliminating SHS exposure and reducing tobacco use include attaining universal (1) smoke-free home, car, school, work, and play environments, both inside and outside, (2) treatment of tobacco use and dependence through employer, insurance, state, and federal supports, (3) implementation and enforcement of evidence-based tobacco-control measures in local, state, national, and international jurisdictions, and (4) financial and systems support for training in and research of effective ways to prevent and treat tobacco use and SHS exposure. Pediatricians, their staff and colleagues, and the American Academy of Pediatrics have key responsibilities in tobacco control to promote the health of children, adolescents, and young adults.

Education is the key to protecting children against smoking: What parents think and do

“…However, previous research with adolescents has shown that good quality smoking-specific parental communication, demonstrated by a constructive and respectful manner, was a deterrent to smoking initiation among the adolescents [17,26]. Further, the overall approach of the parents in this study who discussed smoking with their children is consistent with recommendations and suggestions of authorities and experts in the field of youth smoking prevention [16,18,[27][28][29].…”

“…This is consistent with the perspective that a comprehensive, multichannel approach is required to achieve the greatest effect for smoking prevention [3,16]. Although parents thought that smoking prevention education needs to be carried out at the elementary level in school, some parents did not know whether smoking was addressed at their children's schools.…”

“…In addition to proactive, good quality discussions with their children that are inclusive of the topic, it is suggested by authorities in the field that parents talk with their children about their disapproval of the behaviour. Further, because of the potential for emulation of parental smoking, it is essential for parents who smoke to (a) talk with their children about why they started to smoke and about the power of their addiction; (b) let their children know that smoking is unacceptable and they do not want to smoke, are aware it is bad for their health, and would like to quit; and (c) avoid smoking in their children's presence and tell their children why that is the case [16,18]. It is argued that parents who smoke still can have an influence against the behaviour [18,28].…”

“…These factors can function as protection against smoking or as risk for it [3]. One factor identified in the literature as potentially protective is parental communication with children about the behaviour [16][17][18][19]. Yet, little is known about parental smoking-specific communication with young and preadolescent children.…”

The Acceptability of Incorporating a Youth Smoking Prevention Intervention in the Pediatric Emergency Department

“…12 However, there is an unmet need for the use of child tobacco prevention interventions in health care settings. Although the American Academy of Pediatrics (AAP) recommends that child tobacco prevention counseling should be given during medical visits, 13 few parents are receiving such interventions. 14–18 …”