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.
Highlights
Tobacco use is the leading preventable cause of death and illness in the United States, causing more than 443 000 deaths each year.[1]
Generation; fires attributable to smoking; the economic costs of purchasing tobacco and tobacco-use materials; litter and debris from tobacco products; additional cleaning and maintenance of facilities in which tobacco is used; the health care and emotional costs of diseases associated with tobacco use and secondhand tobacco-smoke (SHS) exposure; and the costs to families and society because of poor health and lost productivity.[2]
Initiation of tobacco use is often instigated by exposure to tobacco use by parents or peers, depiction in movies and other media, advertising targeting children and adolescents, and other environmental and cultural factors.[3,4,5,6,7,8,9,10,11,12]
Summary
Tobacco use is the leading preventable cause of death and illness in the United States, causing more than 443 000 deaths each year.[1]. -cessation efforts after delivery, (3) counsel parents to prevent and eliminate children’s exposure to SHS, (4) counsel preadolescents and adolescents to prevent initiation of tobacco use, and (5) counsel adolescents and parents to quit using tobacco Important adjuncts to these efforts include quitlines and pharmacotherapies for tobacco-use cessation.[14,27,28] Quitlines (toll-free telephone-based tobacco usecessation services that offer evidencebased information and counseling support, including referral of the tobacco user to his or her primary care provider for pharmacotherapies) are an effective way to deliver tobacco usecessation services.[28] Quitlines are available throughout the United States, Canada, and many other countries. Many AAP statements have tobaccorelated content and provide additional detail on specific topics (Table 1), and additional resources are available (Table 2)
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