Ghidei W, Brottman G, Lenne E, Quan T, Joseph A.
INTRODUCTION: Measurement of cotinine, a biomarker of tobacco
smoke exposure, can accurately identify children at risk of health consequences
from secondhand smoke. This study reports perspectives from pediatric health
care providers on incorporating routine cotinine screening into well-child
visits.
METHODS: Key informant interviews (N = 28) were conducted with
pediatric primary care providers:
physicians, nurse practitioners, and registered nurses.
RESULTS: Themes identified in the interviews included the
following: (a) Cotinine screening would assess children's exposure to tobacco
smoke more reliably tan parental report; (b) Addressing positive cotinine
screening results might require additional resources; (c) Wheezing and a
history of emergency department visits increased the salience of cotinine
screening; and (d) A better understanding of the significance of specific
cotinine test values would improve utility.
DISCUSSION: Pediatric providers see advantages of biomarker
screening for tobacco smoke exposure at well-child visits, especially for
children with wheezing, but have concerns about limited capacity for follow-up
with parents.
