Training Pediatric Residents to Prevent Tobacco Use

Objective. To assess the effectiveness and acceptability of incorporating the National Cancer Institute (NCI) Guide to Preventing Tobacco Use During Childhood and Adolescence into pediatric training. Design. Preintervention and postintervention self-reported surveys for residents receiving training and postintervention baseline surveys for those residents not receiving training. Measures include: (1) a self-reported knowledge, attitude, and behavior survey of residents; and (2) physician behavior reports from parent exit interviews. Setting. A hospital-based pediatric residency program and continuity clinic. Subjects. Pediatric residents and parents of pediatricpatients seen for well child examinations. Interventions. Structured NCI smoking cessation curriculum modified for delivery during scheduled teaching activities. Results. The NCI training was acceptable and perceived as important by residents. Many did not recall receiving the materials or training. Trained residents who remembered the intervention improved their smoking cessation counseling effectiveness. Most patients' parents think it appropriate for physicians to ask; however, most reported not having been asked about smoking or environmental smoke exposure. Conclusions. For residents to learn effective prevention counseling strategies, systematic, reinforced preventive educational curricula must become an institutionalized part of residency training.