Recommended questions (family members and caregivers)

In an attempt to reduce parental smoking and decrease children’s tobacco smoke exposure (TSE), this clinical activity recommends using the Clinical Effort Against Secondhand Smoke Exposure (CEASE) model. CEASE involves a 3-step intervention that is repeated at each visit:

• Ask family members and caregivers whether your patient lives with anyone who uses tobacco products.
• Assist family members and caregivers with quitting tobacco and establishing a tobacco-free home and car or provide nicotine replacement therapy if you want.
• Refer interested family members and caregivers to cessation resources such as telephone quit lines to text services to help cessation.

Recommended questions to be directed to family members or caregivers in CEASE include:

• Does your child live with anyone who uses tobacco?

If the family member or caregiver responds yes, follow-up questions may include:

• Have you smoked a cigarette, even a puff, or vaped in the last 30 days?
• Would you like to receive FREE resources from the Tobacco Quitline?

If you or your practice is interested in prescribing Nicotine Replacement for parents, then you would add this question:

• “Would you like a nicotine patch and gum to help you cut down or quit vaping or smoking?”

After asking these recommended questions, pediatricians should document smoking status in the patient’s electronic health record (EHR). Documenting this status helps:

• Ensure all providers are aware of the patient’s vaping/tobacco use/exposure.
• Show the family's progress over time.

• You and your practice have the information needed to follow up with the family member or caregivers at future visits.

For more information on CEASE, refer to this video.