The pediatrician's role in reducing tobacco exposure in children.

OBJECTIVE: Pediatricians have a unique and important role to play in the prevention and treatment of childhood and adolescent tobacco use, the protection of patients from the harmful effects of environmental tobacco smoke, and the encouragement of smoking cessation among parents. However, because recent research indicates that physician training in tobacco dependence is woefully weak and lacks a model for training, this article constructs a useful approach to this problem. METHODOLOGY: A comprehensive review of the literature served as the basis for the development of a new model for pediatrician training in tobacco dependence. RESULTS: A comprehensive model is presented for training pediatricians in the areas of reducing infant and child exposure to environmental tobacco smoke, preventing youth smoking initiation, and providing smoking cessation assistance for adolescents and parents. CONCLUSIONS: Pediatricians have been called on to play an active role in the antitobacco arena. Because of their unique opportunity to interact with children, adolescents, and parents, pediatricians can and should be antitobacco interventionists. For this to occur, however, additional guidance should be provided to pediatricians during their training to better prepare them to carry out effective assessment and intervention practices. smoking initiation, smoking prevention, smoking cessation, environmental tobacco smoke, pediatricians.

Relapse to smoking after basic military training in the U.S. Air Force.

This study examined predictors of smoking relapse in the year after the mandatory smoking ban during basic military training (BMT) in the U.S. Air Force. Participants were all smokers who completed BMT from August 1995 to August 1996 and relapsed to smoking in the subsequent year (N = 4,303). Results demonstrated that the vast majority of airmen (69.8%) returned to smoking within 1 month after BMT and that most (90%) were still in training status when they smoked their first cigarette after BMT. Relapsed smokers appeared more motivated to quit smoking at 1-year follow-up compared with when they were in BMT. Individuals making serious quit attempts after BMT were younger and had greater levels of physical activity, more confidence in quitting, and more favorable perceptions of the BMT ban than individuals not attempting to quit. Based on these findings, recommendations are discussed for improving abstinence rates after BMT.

Where do diets, exercise, and behavior modification fit in the treatment of obesity?

Obesity is a significant public health concern that affects a growing number of people in the United States and throughout the world. While substantial advances have been made in the development of new pharmacotherapies and in understanding the biological underpinnings (e.g., genetics and physiology) of obesity, lifestyle modification, which involves the application of behavior modification principles to alter eating and activity patterns, is the foundation of any comprehensive obesity management. The purpose of this article is to provide a practical overview of the benefits of dietary and activity change and to review behavior modification principles that have been used successfully in obesity management.

Survey of pediatric hospitals' preparation programs: evidence of the impact of health psychology research.

A survey of all 123 nonchronic-care pediatric hospitals in the United States revealed that 75% of hospitals responding had greatly increased the use of effective medical procedure preparation technologies, such as filmed modeling and coping skills instruction, in comparison to the last survey. Respondent characteristics such as position (e.g., nurse, child life worker, physician), degree (e.g., RN, MA, PhD), and length of time in the position failed to predict the type of techniques selected, but higher respondent knowledge and more psychological sources of preparation information did predict the use of preparation techniques used for drawing blood that experts rated as more effective. Challenges for more effective dissemination of research in the future are considered, as is the need for increased study of research-implementation links.