Docs Must Talk to Patients About Secondhand Smoke

MONDAY, Oct. 3, 2005 (HealthDay News) -- Doctors need to counsel patients about the dangers of secondhand smoke, also, whenever they ask their patients about direct tobacco use, three U.S. health experts urge in a statement in the September/October issue of Families, Systems & Health.

The authors -- who include members of the Medical Society of the State of New York Task Force on Tobacco -- say there are good reasons for doctors to combine counseling about direct tobacco use and secondhand smoke. Combining the two types of counseling would be more efficient than doing them separately, first of all. Second, convincing patients about the dangers of secondhand smoke may lead them to insist on having a smoke-free home, which will lower their health risks and might also encourage other smokers in the home to quit.

Currently, family doctors and pediatricians ask less than half of parents about secondhand smoke in the home and counsel only about a third of parents on how secondhand smoke can harm their children, the authors wrote.

They also noted that more people are affected by secondhand smoke than by direct tobacco use. Broader counseling about secondhand smoke could apply to 60-70 percent of the U.S. population, whereas only about 22 percent of the population actually smokes.

The experts propose that secondhand smoke counseling be combined into the existing 5As model recommended by the U.S. Preventive Services Task Force.

The 5As are:

• Ask whether patients use or have used tobacco;
• Advise by urging patients to avoid all exposure to secondhand smoke for themselves and family members while explaining the risks of secondhand smoke;
• Assess by determining how willing patients are to change behavior to avoid secondhand smoke;
• Assist by helping patients make changes if they want;
• Arrange follow-up by providing additional support in subsequent visits.

Secondhand smoke kills about 50,000 people each year in the United States, about the same number of people who die from colon cancer.

"Although certain populations are particularly vulnerable [e.g., children and patients with coronary artery disease or asthma], everyone who is exposed has increased risk for heart disease and other diseases," the authors wrote.

More information

The American Cancer Society has more about secondhand smoke.