Pediatric Office-based Tobacco Screening and Prevention

Abstract

<P>Tobacco use is the leading cause of adult morbidity and mortality in the United States. The majority of adult smokers have their first cigarette before the age of 18. Given that cigarettes are highly addictive, it is critical to target smoking prevention efforts in the pediatric age range. In addition to the long-term repercussions of adolescent tobacco use, there are immediate adverse health effects such as increased incidence of upper respiratory infection, cough, asthma, sinusitis, infertility, poor growth, and decreased lung function. There is also strong evidence that environmental tobacco smoke (ETS) induces or exacerbates many pediatric illnesses including asthma, sudden infant death syndrome, otitis media, pneumonia, cough, abnormalities in cholesterol, coronary artery disease, and cancer. In utero exposure to tobacco products is associated with spontaneous abortion, low-birth weight, sudden infant death syndrome, and cognitive and behavioral problems. Parental smoking is a strong correlate of tobacco use among adolescents. Thus, tobacco use and exposure is an important pediatric health indicator.</P> <H4>ABOUT THE AUTHOR</H4> <P>Sarah E. Wiehe, MD, MPH, is with Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine and Regenstrief Institute, Inc., Indianapolis, IN.</P> <P>Address correspondence to: Sarah Wiehe, MD, MPH, 410 West 10th Street, HS1020, Indianapolis, IN 46202; fax 317-278-0456; or e-mail <a href="mailto:swiehe@iupui.edu">swiehe@iupui.edu</a>. </P> <P>Dr. Wiehe has disclosed no relevant financial relationships.</P> <H4>EDUCATIONAL OBJECTIVES</H4> <OL> <LI>Review the current recommendations for tobacco prevention and screening in the pediatric clinical setting.</LI> <LI>Determine the evidence supporting clinical interventions for primary prevention of youth smoking.</LI> <LI>Discuss the evidence supporting available interventions for smoking cessation among adolescents and reduction of environmental tobacco smoke exposure from household members.</LI> </OL>