SECONDHAND SMOKE EXPOSURE FUNCTIONALITY IN LMR

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• SECONDHAND SMOKE EXPOSURE FUNCTIONALITY IN LMR
• Cecilia Vieira, MSc
• Jonathan Winickoff, MD MPH
• Partners HealthCare Tobacco Treatment Retreat
• September 5, 2008

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Objectives

• Offer evidence that addressing secondhand smoke
  exposure (SHS) is important
• Demonstrate SHS exposure functionality in LMR
• Show data on use of the functionality
• Show data on prevalence of SHS exposure among
  children seen at MGH pediatric practices

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Background

• Secondhand smoke (SHS) exposure is a major cause
  of morbidity and mortality in the United States
• SHS exposure can cause heart disease and lung
  cancer in nonsmoking adults and respiratory
  problems, ear infections, asthma attacks,
  decreased lung growth, exercise intolerance, and
  sudden infant death syndrome (SIDS) in children
• Even brief exposure can be harmful There is no
  safe level of exposure
• Parental smoking increases smoking uptake by
  children worsens cycle of poverty for families

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Background

• Parents see childs clinician more often than
  their own clinician
• Chance to intervene teachable moment
• AMA statement
• What parents say they want from their childs
  clinician referral to Quitworks and medication

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Objective of the initiative

• Help to ensure that every child served by
  Partners HealthCare has the best chance to grow
  up in a smoke free home, the best chance to
  remain a non-smoker, and the best chance to have
  parents who are free from tobacco dependence

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The functionality

• Support for the pediatric clinician to
• Document SHS exposure status
• Advise parents to establish smoke-free rules
  for the home and car
• Assist parents and relatives to quit smoking

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The functionality

• Available for pediatrics since March 7 at

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Click to document SHS exposure.
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Choose one of the coded responses
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Click on references to offer assistance
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Click Offer Assistance to print handout
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Adoption of the functionality
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Prevalence of SHS exposure at home - Partners
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Prevalence of SHS exposure of children by practice
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Next steps

• Extend the functionality to all Partners
  pediatric practices
• Train clinicians to use it
• Improve the functionality, based on users
  suggestions
• Extend the functionality to all Partners adult
  internal medicine practices

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Special thanks to

• Partners Community Benefits Office
• High Performance Medicine, Team 3
• Partners Tobacco Treatment Taskforce
• Janet Cygielnik, Ann-Marie Duffy, Jonathan
  Einbinder, Rupali Gurjar, Brian Hingston, Bethany
  Hipple, Dan Housman, Janak Joshi, Steve Morgan,
  Rachel Regier, Anne Richmond, Nancy Rigotti

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Suggestions

• MGHCeaseTobaccoinLMR_at_partners.org