Pediatric Residency Training on Tobacco

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Abstract
Objective. Pediatricians have a unique role to play in the antismoking arena. However, few pediatric residency training programs prepare residents to meet the tobacco challenge. This study evaluates the effects of a comprehensive pediatric residency training program on tobacco on resident tobacco intervention behaviors, as well as on changes in the behavior of patients and their parents/guardians. Methods. Pediatric residents were exposed to a comprehensive training program on tobacco. Baseline and follow-up surveys of residents, parents/guardians, and patients were used to assess the effects of the training program. A quasi-experimental design permitted unambiguous evaluation of the program's effects on resident intervention behaviors. Results. The comprehensive training program on tobacco led to marked and significant changes in resident intervention on tobacco. Many of these changes were supported by parents' and patients' reports. In turn, resident intervention on tobacco led to a significant increase in the likelihood that parents would maintain a “smoke-free household.” Significant changes in the prevalence of parental smoking were not found, although the trend during 3 years of follow-up was in the desired direction. A high proportion of residents reported that they intervened on tobacco in patients at baseline and follow-up, but too few patients were sampled to permit analysis of the impact on changes in smoking. Conclusions. Comprehensive training on tobacco had a positive and powerful effect on the tobacco intervention behavior of pediatric residents. In turn, intervention on tobacco by pediatric residents may have a significant impact on patients and their parents. These findings underscore the efficacy of pediatric residency training on tobacco, and it is hoped that they will serve as an impetus for other pediatric residency programs to introduce training on tobacco.