The 13th World Conference on Tobacco OR Health

Objective: Exposure to second-hand smoke in homes has well-established health consequences for children; pediatricians and family practitioners are ideally positioned to address smoking by parents in homes with children. The objectives of the study were to explore practices of Canadian pediatricians and family practitioners in advising parents about second-hand smoke (SHS) in homes, and to examine implications for physician training.

Methods: A detailed questionnaire on tobacco-related attitudes, role perceptions, and practices was mailed to 1600 Canadian family physicians and pediatricians. French language questionnaires were sent to those practicing in Québec. After follow-up with non-responders, and removal of those who were ineligible, the corrected response rate was 65%.

Results: More than 80% of respondents agree they have a major role in identifying parents who smoke when their patients are children, and in advising on the reduction of SHS in homes. However, pediatricians are less likely than family practitioners to perceive that they have a major role in helping adult household members to quit. Role perceptions are reflected in practice: pediatricians are more likely than family practitioners to advise parents to cut down or quit smoking, but are less likely to take specific steps to help parents quit. Both specialties are more likely to advise parents about smoking when a child patient has respiratory problems. Both family practitioners and pediatricians can increase their tobacco-related practice with parents. Differences in practice patterns suggest that practice change efforts should be tailored to individual specialties, possibly increasing pediatricians' role in helping parents quit smoking.