Tobacco Use and Nicotine Addiction in Pediatric Cardiology Practices

Background: Pediatric cardiologists, who would presumably recognize tobacco use and exposure to be health hazards, may not address this risk in their clinical practice. We sought to determine the current clinical practice patterns of pediatric cardiologists with regard to smoking and passive smoking in their clinical practices.

Methods: We sent an anonymous electronic survey to the membership of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and the Pediheart online community in February 2021. This survey addressed their training in tobacco related issues, their current practices in screening for smoking and secondhand smoke and their recommendations for treatment in clinical practice.

Results: 82 of 87 respondents were pediatric cardiologists. Respondents had a range of 1 to 33 years in practice. More than half reported very little or no formal training regarding smoking (52.3%) or smoking cessation (60.5%).

Respondents rarely or never advised a smoking ban in the following contexts: adult congenital heart disease patients 51.3%, general pediatric cardiology patients 48.8% and interstage single ventricle infants (arguably their highest risk patients) 40.5%.

Their programs screened patients for tobacco use in the following settings: hospitalization (74.6%), outpatient pediatric visits (76.3%), and outpatient adult congenital visits (93.1%). They personally screened patients 29.3% for hospitalization, 59.3% for outpatient pediatric visits, and 60.2% for outpatient adult congenital visits. For screening parents and other household members, most answered yes that their programs do screen, while most answered they personally do not. Respondents answered that lack of time (44.9%) and “not my role in patient care” (21.5%) as the main barriers they face.

Conclusion: Our survey suggests that pediatric cardiologists do not appear to place a high priority on addressing smoking and secondhand smoke exposure in their day to day practices despite the known risks associated with tobacco use and exposure.