Interagency Committee on Smoking and Health
Meeting Summary: March 5, 2007
Reducing Exposure to Secondhand Smoke
NO SAFE LEVEL
Jonathan Winickoff, M.D., Tobacco Consortium,
American Academy of Pediatrics
Dr. Winickoff began by dedicating his remarks to Dr. Julius Richmond who
encouraged him to pursue his goal of eliminating secondhand smoke exposure in
children.
Data from the American Academy of Pediatrics (AAP) suggest that counseling by
doctors might encourage nonsmokers to protect themselves from smokers by
enforcing a no-smoking rule in the house. However, the data also suggest that
many clinicians miss the opportunity to provide this advice. Dr. Winickoff
suggested to the Committee that systematic assessment and counseling for
secondhand smoke exposure be made a priority.
While many parental smokers continue to fall through the healthcare "cracks"
because they don't often see their own primary doctor, this is not the case for
their interaction with pediatricians. In fact, most parents will see their
child's doctor 15 times in the first two years of each child's life. Therefore,
to treat parental smokers and to protect children, the child healthcare setting
should be used to establish no-smoking rules in the home and car and link
parents to available quitlines and other cessation services in the state.
Similar to the approach for lead poison testing, Dr. Winickoff suggested an
approach to testing for secondhand smoke exposure. A nationally representative
survey conducted by Mississippi State University found that 78% of nonsmoking
parents and 82% of smokers would accept a blood test to measure secondhand smoke
exposure in their children. This kind of documentation of exposure might help
non-smoking parents better advocate for safer environments for their children.
A surprising finding from AAP's 2006 survey found that health beliefs about
secondhand smoke are not associated with home and car smoking bans. People know
that secondhand smoke is dangerous and have known it for years. However knowing
that contamination continues to exist after the cigarette is extinguished is a
newer concept to many and appears to lead to a 2-3 fold increase in support for
smoking bans in public places.
Dr. Winickoff closed his remarks by reiterating his vision and his desire to
help people understand there is "NO SAFE LEVEL" from exposure to secondhand
smoke. His vision focuses on using the child healthcare setting as a point of
access to the families of every child exposed to secondhand smoke, and every
parental smoker. The clinical tools exist for this effort but they must be
tailored by each state and then widely disseminated.
Following Dr. Winickoff's remarks, Dr. Noonan introduced the next speaker.
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