Tobacco use and smoke exposure are at the heart of a world-wide pandemic of tobacco-related disease and literally condemn millions of young people to a life-time of addiction and premature morbidity and mortality. In order to protect children and adolescents from the scourge of tobacco use and smoke exposure, pediatricians must be prepared to intervene for behavior change and to advocate for legislation, policy, and resources aimed at reducing tobacco use and creating a smoke-free environment. The pediatric residency training years provide important opportunities to prepare pediatricians to meet the tobacco challenge.
This current review supports the efficacy of active and experiential approaches to learning in order to prepare residents in pediatric preventive cardiology, environmental and community pediatrics, and primary care to play a leadership role in protecting children and adolescents from the harm of tobacco use and exposure. With proper training, pediatric residents should be able to acquire the knowledge, skill, and confidence to address tobacco use and smoke exposure in their clinical practice. There still is much work to be done, including addressing professional norms which contribute to reluctance on the part of pediatricians and residents to go beyond ask and advise to assist and arrange as well as to address tobacco use in parents. As training to intervene becomes more accepted and integrated within the formal pediatric residency curriculum, professional norms and mores will change, and the next generation of pediatricians will be better prepared to stem the tobacco pandemic.