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“They’re uneasy about prescribing medication for them.
But if I have to balance the risks of prescribing versus the risks
of smoking, I should recommend nicotine replacement therapy for
addicted parents.”
Meurer says
research by the Institute of Medicine found good evidence that
smoking is both a cause and trigger of childhood asthma –
in addition to well-documented risk of low birth weight, miscarriages
and SIDS. Then there’s the risk to the parents.
“Twenty-
to thirty-thousand children lose parents to smoking every year
in this country,” he says. “They go on Supplemental
Security Income at a price of $1 billion a year.” He says
he doesn’t want kids to suffer physically, emotionally or
economically. “Each person we help to quit makes a colossal
difference.”
As Associate
Professor of Pediatrics and Chief of General Pediatrics at the
Medical College of Wisconsin in Milwaukee, Meurer has established
a systematic approach for the entire pediatrics team to treat
parental tobacco use. They follow U.S. Public Health Clinical
Practice Guidelines: Treating Tobacco Use and Dependence, which
recommends asking about tobacco use at every visit and strongly
advising patients to quit. If the parents don’t want to
quit, the pediatricians urge them not to smoke around the kids,
especially in an enclosed area like a car or house.
Parents
Receptive To Tobacco Treatment
Meurer says 70 percent of his patients’ parents who smoke
want to quit and are receptive to his treatment. “In fact,
when we don’t ask they say, ‘What’s up?’
It’s like we don’t care.”
Meurer’s
staff refer parents and teens to the Wisconsin Tobacco Quit Line.
Patients can access free counseling by calling the Quit Line at
1-877-270-STOP.
“It’s
a great system of support for the community,” Meurer says.
Treating
Parental Tobacco Use: Quick, Easy and Important
Treating parental addictions to tobacco is a team effort, Meurer
says, by the entire pediatrics staff. It doesn’t take much
time – a minute or two per parent who smokes.
As medical
director of the Downtown Health Center (DHC), Meurer worked with
the University of Wisconsin’s Center for Tobacco Research
and Intervention (UW-CTRI) to establish guidelines for taking
tobacco use status as a vital sign, treating tobacco use and measuring
results.
“If
it’s a priority and someone is measuring it, it will get
done,” he says. In fact, the Joint Commission on Accreditation
of Healthcare Organizations (JCAHO) has made tobacco treatment
a requirement for hospital staff when treating certain illnesses.
DHC is a joint
program of the Medical College and Children's Hospital of Wisconsin
(which is ranked as the number-three children’s hospital
in the nation by Child magazine). At DHC, they offer the Fax to
Quit program, which allows tobacco users to sign up for Quit Line
services before leaving the doctor’s office. Then a Quit
Line coach calls the parent back at a time specified by the parent.
Meurer is
also the director of Fight Asthma Milwaukee Allies. He works hard
to let parents know how their second-hand smoke is affecting their
kids with asthma.
Teaching
Tomorrow’s Pediatricians to Treat Smoking
If that wasn’t enough, he’s also an associate professor
who encourages medical students and pediatric residents to treat
tobacco addictions. “They are particularly receptive,”
he says. “I use handouts from UW-CTRI. The students like
their brochures and talking points. It’s all about getting
them excited about advocacy and appealing to our responsibility
as physicians.”
To
locate your local UW-CTRI Outreach specialist, click
here or call (608) 265-4869.
More About Tobacco Treatment
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