Table 3.
Attitude and practice factors associated with performing tobacco counseling among PED/UC healthcare professionals
| Attitude and practice factors | The 5 As of tobacco counseling | |||||
|---|---|---|---|---|---|---|
| Asked whether parents used tobacco (n=16) | Asked whether patients were exposed to tobacco smoke (n=21) | Advised parental smokers to quit smoking (n=15) | Advised parental smokers not to smoke around patient (n=21) | Assessed parental smokers’ interest in quitting smoking (n=6) | Assisted/Arranged parental smokers (n=5) | |
| At least moderately confident in: | ||||||
| Providing guidance on the harmful effects of smoking on children | 14 (87.5) | 18 (85.7) | 13 (86.7) | 18 (85.7) | 6 (100.0) | 5 (100.0) |
| Advising parental smokers to stop smoking | 8 (50.0) | 9 (42.9) | 7 (46.7) | 10 (47.6) | 5 (83.3)* | 4 (80.0) |
| Assessing barriers to quitting | 4 (25.0) | 4 (19.0) | 4 (26.7) | 5 (23.8) | 4 (66.7)** | 3 (60.0)* |
| Assisting parental smokers by discussing smoking cessation | 5 (31.3) | 5 (23.8) | 4 (26.7) | 6 (28.6) | 4 (66.7)* | 4 (80.0)** |
| Providing quitting materials | 7 (43.8) | 8 (38.1) | 5 (33.3) | 8 (38.1) | 4 (66.7) | 4 (80.0) |
| Enrolling/referring to the Quitline | 4 (25.0) | 4 (19.0) | 3 (20.0) | 5 (23.8) | 3 (50.0)* | 2 (40.0) |
| Recommending NRT medications | 1 (6.3) | 1 (4.8) | 1 (6.7) | 2 (9.5) | 1 (16.7) | 1 (20.0) |
| Prescribing NRT medications | 1 (6.3) | 1 (4.8) | 1 (6.7) | 1 (4.8) | 1 (16.7)* | 1 (20.0)* |
| At least moderately: | ||||||
| Easy to identify patients exposed to tobacco smoke and to counsel parental smokers | 7 (43.8) | 9 (42.9) | 6 (40.0) | 10 (47.6) | 4 (66.7) | 3 (60.0) |
| Effective in identifying patients exposed to tobacco smoke and counseling parental smokers | 5 (31.3) | 5 (23.8) | 4 (26.7) | 6 (28.6) | 4 (66.7)** | 3 (60.0)* |
| Optimistic that offering standardized efforts to routinely identify patients exposed to secondhand smoke and counseling parental smokers will reduce patients’ exposure | 11 (68.8) | 14 (66.7) | 11 (73.3) | 14 (66.7) | 4 (66.7) | 3 (60.0) |
| Prepared to assist parental smokers to quit smoking | 7 (43.8)* | 7 (33.3) | 5 (33.3) | 7 (33.3) | 5 (83.3)*** | 44 (80.0)** |
| Tobacco counseling is important to: | ||||||
| Patients’ physical health | 15 (93.8) | 19 (90.5) | 13 (86.7) | 18 (85.7) | 6 (100.0) | 5 (100.0) |
| Patients’ future healthcare visits | 11 (68.8) | 15 (71.4) | 11 (73.3) | 14 (66.7) | 5 (83.3) | 4 (80.0) |
| Parental smokers’ physical health | 12 (75.0) | 16 (76.2) | 13 (86.7) | 17 (81.0) | 6 (100.0) | 5 (100.0) |
| Agree that barriers include: | ||||||
| Inadequate reimbursement for time it takes to counsel | 4 (25.0) | 6 (28.6) | 5 (33.3) | 6 (28.6) | 1 (16.7) | 1 (20.0) |
| Lack of professional training in the area of cessation counseling | 12 (75.0) | 16 (76.2) | 10 (66.7) | 16 (76.2) | 3 (50.0)* | 3 (60.0) |
| Time limitations | 14 (87.5) | 19 (90.5) | 14 (93.3) | 19 (90.5) | 6 (100.0) | 5 (100.0) |
| Parental smokers’ lack of interest in being counseled | 13 (81.3) | 17 (81.0) | 11 (73.3)* | 17 (81.0) | 4 (66.7) | 3 (60.0) |
| Parental smokers’ anger | 9 (56.3) | 13 (61.9) | 10 (66.7) | 12 (57.1) | 5 (83.3) | 3 (60.0) |
| Fear that counseling parental smokers is not effective | 8 (50.0) | 10 (47.6) | 7 (46.7) | 10 (47.6) | 3 (50.0) | 2 (40.0) |
| Lack of easily accessible information to give to parents | 11 (68.8) | 15 (71.4) | 9 (60.0) | 13 (61.9) | 3 (50.0) | 2 (40.0) |
| Hard to make systems level policy changes | 10 (62.5) | 13 (61.9) | 9 (60.0) | 12 (57.1) | 4 (66.7) | 3 (60.0) |
NRT: nicotine replacement therapy.
Statistical significance from bivariate analyses: ***p<0.001, **p<0.01, *p<0.05.