Tobacco counseling at well-child and tobacco-influenced illness visits

opportunities for improvement.

Susanne E. Tanski, Jonathan D. Klein, Jonathan P. Winickoff, Peggy Auinger, Michael Weitzman

    Research output: Contribution to journalArticle

    Abstract

    OBJECTIVE: To assess the frequency of clinician-reported delivery of counseling for avoidance of child environmental tobacco smoke (ETS) exposure and tobacco use at periodic well-child visits and at illness visits for asthma and otitis media (OM). METHODS: Combined data from the National Ambulatory Medical Care Survey and the outpatient portion of the National Hospital Ambulatory Medical Care Survey from 1997 to 1999 were analyzed. The frequency of pediatric visits (<or=18 years) that included clinician-reported counseling for tobacco use/exposure prevention was assessed. Diagnosis-specific visits were determined by using International Classification of Diseases, Ninth Revision codes for asthma (493-), OM (381-, 382-), and well-child visits. Bivariate and regression analyses were performed. RESULTS: Of 33 823 ambulatory care visits by children, 1.5% were reported to include delivery of tobacco counseling. Only 4.1% of well-child visits, 4.4% of illness visits for asthma, and 0.3% of illness visits for OM included tobacco counseling. With the use of logistic regression models, adolescent patient visits (13-18 years) were more likely to include delivery of tobacco counseling than younger child visits [OR = 15.8, 95% CI (7.5-33.5)]. Visits by children with Medicaid and those seen by a nurse practitioner or a physician's assistant were also more likely to include tobacco counseling (odds ratio: 1.6; 95% confidence interval: 1.002-2.50; and odds ratio: 3.0; 95% confidence interval: 1.5-6.0, respectively). There were no significant differences in counseling delivery by race, ethnicity, or clinician specialty. CONCLUSIONS: Rates of tobacco counseling at well-child visits and at illness visits for diagnoses directly affected by tobacco use and ETS are extremely low. Significant opportunities exist to improve counseling rates for child ETS exposure and adolescent tobacco use in primary care.

    Original languageEnglish (US)
    JournalPediatrics
    Volume111
    Issue number2
    StatePublished - Feb 1 2003

    Fingerprint

    Tobacco
    Counseling
    Tobacco Use
    Otitis Media
    Smoke
    Health Care Surveys
    Asthma
    Logistic Models
    Odds Ratio
    Confidence Intervals
    Physician Assistants
    Nurse Practitioners
    Medicaid
    International Classification of Diseases
    Ambulatory Care
    Primary Health Care
    Outpatients
    Regression Analysis
    Pediatrics

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health

    Cite this

    Tanski, S. E., Klein, J. D., Winickoff, J. P., Auinger, P., & Weitzman, M. (2003). Tobacco counseling at well-child and tobacco-influenced illness visits: opportunities for improvement. Pediatrics, 111(2).

    Tobacco counseling at well-child and tobacco-influenced illness visits : opportunities for improvement. / Tanski, Susanne E.; Klein, Jonathan D.; Winickoff, Jonathan P.; Auinger, Peggy; Weitzman, Michael.

    In: Pediatrics, Vol. 111, No. 2, 01.02.2003.

    Research output: Contribution to journalArticle

    Tanski, SE, Klein, JD, Winickoff, JP, Auinger, P & Weitzman, M 2003, 'Tobacco counseling at well-child and tobacco-influenced illness visits: opportunities for improvement.', Pediatrics, vol. 111, no. 2.
    Tanski SE, Klein JD, Winickoff JP, Auinger P, Weitzman M. Tobacco counseling at well-child and tobacco-influenced illness visits: opportunities for improvement. Pediatrics. 2003 Feb 1;111(2).
    Tanski, Susanne E. ; Klein, Jonathan D. ; Winickoff, Jonathan P. ; Auinger, Peggy ; Weitzman, Michael. / Tobacco counseling at well-child and tobacco-influenced illness visits : opportunities for improvement. In: Pediatrics. 2003 ; Vol. 111, No. 2.
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