TABLE 7-1

Evidence-Based Recommendations to Prevent Tobacco Exposure

PrenatalObtain smoking history from mothers; provide explicit smoking-cessation message before and during pregnancyGrade A Strongly recommend
Supportive actions:
    Identify resources to support maternal smoking-cessation efforts.
    Advocate for school and community-based smoke-free interventions
    See “Perinatal Factors” section
0 to 4 ySmoke-free home environmentGrade B Strongly recommend
Reinforce this message at every encounter, including urgent visits for respiratory problemsGrade C Recommend
Supportive actions:
    Provide information about health benefits of a smoke-free home to parents and children
    Advocate for school- and community-based smoke-free interventions
5 to 10 yObtain smoke-exposure history from child, including personal history of tobacco useGrade C Recommend
Counsel patients strongly about not smoking, including providing explicit information about the addictive and adverse health effects of smokingGrade C Recommend
11 to 21 yObtain personal smoking history at every nonurgent health encounterGrade B Strongly recommend
Explicitly recommend against smokingGrade B Strongly recommend
Provide specific smoking-cessation guidanceGrade B Strongly recommend
Supportive actions:
    Use 5 A questions to assess readiness to quit
    Establish your health care practice as a resource for smoking cessation
    Provide quit-line phone number
    Identify community cessation resources
    Provide information about pharmacotherapy for cessation
    Advocate for school and community-based smoke-free interventions
  • Grades reflect the findings of the evidence review; recommendation levels reflect the consensus opinion of the expert panel; and supportive actions represent expert consensus suggestions from the expert panel provided to support implementation of the recommendations (they are not graded).