Clearing the Air: Children's Respiratory Risks Associated with Secondhand Smoke Exposure

Alabama Nurse,  Jun-Aug 2005  by Turner-Henson, Anne

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* Ask-Systematically identify secondhand smoke exposure at every visit/encounter, add the following standard questions to each encounter form: Does anyone smoke in the child's home or car? If so, who?

* Advise-Strongly urge the family to have a smoke-free home and car; and encourage all tobacco users to quit

* Assess-Determine willingness to make a smoke free home/car, or in the case of smokers to make a quit attempt

* Assist-Aid the family in having a smoke free home/car or aid the family member in quitting

* Practical counseling (problem solving/skills training)

* Intra-treatment social support (I am here to help you)

* Extra-treatment social support (ask others for help, like family members)

* Arrange

* Schedule follow-up, preferably within the first week of quitting

In pediatrics, we often add an extra 'A' called anticipatory guidance. In using anticipatory guidance the nurse would provide information to families about the dangers of secondhand smoke exposure and ways to keep the home and car smoke free. Alabama nurses interested in learning how to implement the five A's in their practice setting should contact the Tobacco Prevention and Control Division of the Bureau of Chronic Disease Prevention of the Alabama Department of Public Health (call 1-800-252-1818 for further information).

The Alabama Department of Public Health has recently initiated a quitline, a telephone-based tobacco cessation service in which counselors are available to answer questions about the cessation process and help them develop an effective plan for quitting. Key components about the Alabama quitline include:

* Hours of Operation

* 24-hour answering service

* Live counseling 8am-8pm Monday-Friday

* Weekend hours to be added if need arises

* Referral to local cessation services

* Telephone Counseling provided by Licensed Professional Counselors

* Up to six proactive calls to patient (more if relapse occurs)

* Healthcare Providers and Hospitals

* Fax Referral Program-Healthcare providers can fax patient information and counselors from the Quitline will call patient. Call 1-800-784-8669 for more information.

* Progress reports on patients consented to Quitline

* Consultation for implementation and training on the USPHS Clinical Practice Guideline for Treating Tobacco Use and Dependence

* Language Services

* English

* Spanish

* Other (translator services connected)

* Educational Materials

* Provide nicotine replacement therapy (NRT) coupons

For children it is important to remember that avoidance of respiratory irritants, such as secondhand smoke is essential in order to allow for maximal growth and maturation of airway functions. Every child should have the right to grow up in a safe and clean indoor air environment. Working together Alabama nurses can strive for the goal that all children have the right to grow up in a smoke-free and healthy environment.

Resources for Secondhand Smoke Exposure (State and National sources)

* Alabama Department of Health, Tobacco Prevention and Control: http://www.adph.org/tobacco/