Parental Tobacco Control in the Child Healthcare Setting

Each year 40% of the worldapos;s children are exposed to tobacco smoke and 166,000 children die from that exposure annually. The 2006 and 2010 U.S. Surgeon General Reports concluded that there is no safe level of tobacco smoke exposure (TSE). The only way to completely protect children from the dangers of household TSE is to help all household members quit. Due to the many health concerns associated with children's TSE, parental tobacco control is a priority within the pediatric setting. Child healthcare clinicians are in a unique position to influence the smoking behaviors of parents, thereby improving the health of their patients. The Clinical and Community Effort Against Secondhand Smoke Exposure (CEASE) is a parental tobacco control intervention that uses an operational form of the U.S. Department of Health and Human Service's (HHS) Treating Tobacco Use and Dependence Guideline in the context of the child's outpatient medical visit. The CEASE method includes three steps (Ask, Assist, Refer) that encompass the goals of the 5A's (Ask, Advise, Assess, Assist, Arrange) in a simplified format, allowing for brief, tailored cessation support for the person who smokes. This paper summarizes the research on the harms of TSE and explores how child healthcare clinicians can most effectively eliminate these health risks to children by implementing CEASE. Finally, we look at legislative initiatives that clinicians can support to help protect children from the harms of TSE.