Trends in U.S. Primary Care Provider Patient Advice Against Secondhand Smoke Exposure: 2008-2010

Background: Recent studies further expose the dangers of secondhand smoke (SHS) to smokers and nonsmokers alike. The health care visit provides a face-to-face opportunity to deliver vital information about those dangers, yet, little is known about primary care providers (PCPs) who address this topic with their patients in clinical practice. Purpose: We examined primary care providers’ advice to patients regarding SHS exposure and the factors promoting such communication. Methods: Data from 3 years (2008, 2009, and 2010) of physician questionnaires (approximately 1250 family/general practitioners, internists, and obstetricians/gynecologists (OBs/GYNs) were used to examine physician advice to patients with children, to smokers and to nonsmokers to prevent or avoid SHS exposure. Using 2010 data we evaluated descriptive statistics and logistic regression for offering patient advice regarding SHS exposure. Results: Web-based data revealed that almost 90% of PCPs advise patients with children to keep their children from being exposed to SHS, 80% advise patients who smoke to avoid exposing others to SHS in their homes and cars, and 70% advise nonsmokers to avoid general exposure to SHS. Logistic regression analysis indicated that OB/GYNs were less likely to engage in SHS counseling than their family practice/general practitioner colleagues. Conclusions: Physician efforts advising patients to avoid SHS exposure varied little in 2008, 2009, and 2010. Primary care providers, particularly OB/GYNs, are encouraged to advise their patients during routine visits to avoid SHS exposure that could compromise fetal health and growth. More extensive tobacco education and targeted specialty guidelines may be required