Sociodemographic and visit differences in screening for household tobacco smoke exposure in pediatric primary care.

Abstract

Pediatric screening for household tobacco smoke exposure (TSE) may help to increase parental access to tobacco treatment and reduce childhood TSE, yet levels remain low. This study aimed to characterize sociodemographic and visit-related factors associated with TSE screening in pediatric primary care. Secondary analysis of electronic health records for all clinic visits (patients 0-18 years) in a metropolitan health system. Modified Poisson regressions examined the association between patient and visit characteristics and TSE screening. TSE screening was documented in 84% of all visits (n = 62,161 patients). TSE screening was more likely among patients who were 3 years or older (3-6 years PR 1.40, 95% CI 1.37, 1.42; 7-12 years PR 1.40, 95% CI 1.38, 1.43; 13+ years PR 1.49, 95% CI 1.47, 1.52), patients with insurance (PR 1.05, 95% CI 1.03, 1.08), and those with a diagnosis of reactive airways disease, bronchiolitis, or wheeze (PR 1.07, 95% CI 1.06, 1.08) or preterm birth (PR 1.04, 95% CI 1.03, 1.06). Pediatric patients with high-risk medical diagnoses were more likely to receive recommended household TSE screening. There are opportunities within pediatric primary care to increase screening for household TSE among younger and underinsured pediatric populations. Pediatric patients with high-risk medical diagnoses were more likely to receive recommended household TSE screening. Levels of household TSE screening were lowest among patients age 2 years and under and those who are underinsured. Increasing systematic screening for household TSE is essential to connect parents who smoke with resources to quit.