Tobacco Screening & Counseling in the Pediatric ED

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Previous studies have shown that the pediatric ED tends to underuse parental tobacco screening and brief cessation counseling. Recently, a study was conducted to look at the attitudes and perceived barriers regarding the implementation and adoption of tobacco screening and cessation counseling of parental smokers among pediatric ED practitioners. The analysis also solicited suggestions for improving the sustainability and maintenance of these practices.

For the study, investigators conducted 30 interviews to identify relevant data, patterns, and themes. Reach factors included targeting parental smokers with children with respiratory diseases, having adequate training of practitioners, and providing “prearranged” counseling packages. Effectiveness factors included practitioner desire for outcomes data about intervention effectiveness, such as changes in children’s secondhand smoke exposure and parental quit rates.

Solutions to increase the adoption of interventions included quick electronic health record prompts and the provision of onsite tobacco cessation experts. Financial support and alignment of strategic plans were also viewed as important factors. Maintenance factors included institutional and technical support, as well as specifically identifying intervention “champions” in the pediatric ED. By highlighting these viewpoints, the researchers concluded that their findings can help guide and direct the development and evaluation of sustainable interventions for treating tobacco use in the pediatric ED.

Source: Journal of Emergency Nursing, July 2014.

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