ORLANDO — The availability of urine cotinine results may prompt physicians to counsel families about the risks of secondhand smoke.
Physicians were more likely to offer smoking cessation counseling to parents and to give other advice about reducing tobacco smoke exposure at home if they had access to urine cotinine results from their pediatric patients, according to a poster presented at the annual meeting of the Society for Research on Nicotine and Tobacco.
Dr. Michael S. McLemore, who was at the University of California, San Diego at the time of the study, and his colleagues recruited 102 low-income families from health clinics around San Diego County.
Families were eligible if they had at least one household member who smoked and a child under age 5 years who was exposed to secondhand smoke at home.
The families were randomized to receive either usual clinical care or counseling. Family counseling included 12 sessions on limiting a child's exposure to secondhand smoke, biofeedback of the child's cotinine levels, and small financial incentives to initiate conversations with pediatricians about the cotinine results.
In addition, the pediatricians whose patients were in the counseling group received the child's urine cotinine lab results.
Of the 28 pediatricians whose patients were in the counseling group, 7 reported that they saw the cotinine results and 21 did not see results. Of those who saw the cotinine results, 86% reported recommending home smoking bans, 71% recommended car smoking bans, and all recommended smoking cessation.
The remaining 21 pediatricians who did not see the cotinine results, but whose patients participated in the counseling sessions, also reported providing counseling to families.
Forty-three percent reported recommending home bans, 26% recommended car bans, and 43% recommended smoking cessation.
The numbers fell even more among the 29 pediatricians whose patients were in the control group. In that group, 38% recommended home bans, 17% recommended car bans, and 24% recommended smoking cessation.
Despite the risks associated with secondhand smoke, the researchers reported that very few pediatricians provide smoking cessation counseling. The research was supported by a grant from the American Heart Association.