Most parents agree: Test children for smoke exposure

The majority of parents agree that children should be tested for tobacco smoke exposure during primary care visits, according to a study published online March 21 in Pediatrics.

The study found that of 477 smoking and nonsmoking parents, 60% say children should be tested for smoke exposure as part of pediatric exams. Among smoking parents, 62% agreed with having children tested. No surveys previously measured parental acceptance of tobacco smoke exposure tests in the context of children's health care visits, according to the study (link).

The findings dispel a misconception that parents who smoke would not want their children tested for tobacco exposure, said study author Jonathan P. Winickoff, MD, associate professor of pediatrics at Massachusetts General Hospital for Children.

"One of the barriers to testing kids for tobacco is: 'Maybe it will alienate parents who smoke,' " he said. "I think that's why the results are so surprising. We found quite the opposite."

Parents with lower education, women, nonwhites and people who live in homes where smoking occurs were more likely to want their child tested, the study showed. These attitudes could reflect fear of greater tobacco exposure in their children or curiosity about whether efforts to prevent exposure are working, the study said.

The results show that tobacco contact weighs heavily on the minds of parents, Dr. Winickoff said, and that tobacco testing is an appropriate responsibility of primary care physicians.

"One interesting thing is parents are going to be real partners with clinicians in finding out if children are exposed," he said.

Although tobacco exposure can be tested a variety of ways, including through urine analysis, the survey found that most parents prefer the test as an add-on to a blood test. The finding helps to decide how best to incorporate tobacco tests into regular examinations, the study's authors said.

More testing for tobacco in children could have positive impacts, such as the discovery of an unknown smoking source. That could be a previously contaminated house or tobacco seepage into a home by way of multiunit housing. Families living in multiunit housing can be exposed to tobacco from other units because of shared airspace, Dr. Winickoff said. Positive tobacco test results in children could prompt more landlords to prevent smoking in their buildings, he added.

The American Medical Association adopted policy in June 2010 that smoking be prohibited in multiunit housing.