Tobacco wars

Chapters poised to protect children from cigarettes, secondhand smoke
AAP Department of Community, Chapter and State Affairs

With challenges in tobacco prevention and cessation, and increased funding for prevention, the release of the AAP policy statement, Tobacco Use: A Pediatric Disease ( Pediatrics 2009;124:1474-1487 ), could not have been timed more perfectly.

Recommendations in the statement for government and advocacy include tobacco-free environments; treatment of tobacco use and dependence; prevention; and tobacco product control. AAP chapters are key to making policy changes recommended in the tobacco statement.

Example of chapter advocacy

The Massachusetts Chapter has been involved in tobacco control initiatives for about 18 years, having influenced policy at the state and local levels, according to chapter President Carole Allen, M.D., FAAP.

Dr. Allen’s interest in tobacco control began as a result of what she witnessed in her personal and professional life. When her son was in high school, she noticed that teachers were permitted to smoke in school buildings. This prompted her to file a request for a policy change with the Arlington town leadership to make all town-owned buildings smoke-free. The article passed, and Arlington became one of the first towns in Massachusetts to enact a smoke-free workplaces policy.

Dr. Allen also observed a high prevalence of parental smoking in her medical practice.

“I felt frustrated that the kids were always sick with asthma attacks and ear infections because of their parents’ tobacco use, and I felt powerless to influence this problem,” Dr. Allen said.

She attended several tobacco control and prevention workshops and brought her knowledge back to the chapter, which asked her to represent it on Tobacco Free Mass. Dr. Allen was elected vice chair and later chair of Tobacco Free Mass, a privately funded coalition of professionals (e.g., lawyers, dentists, health board consultants, physicians).

During this time, the coalition advocated for continued funding of the Massachusetts Tobacco Control Program and laws restricting sales and marketing of tobacco products. It also supported local boards of health in developing smoke-free workplace regulations and testified before the state Attorney General, encouraging tougher regulations around tobacco distribution. Other successes included passage of city and state smoke-free laws and a cigarette tax increase.

The chapter also partnered with other health groups to advocate for a tobacco surtax, which provided health insurance coverage for uninsured children who did not qualify for Medicaid, as well as prescription coverage for some seniors.

The chapter continues its endeavors in what Dr. Allen calls “the tobacco wars.” Efforts include working with the Boston Public Health Commission on a campaign to increase smoke-free building options. Additionally, the chapter partners with the Massachusetts Department of Public Health on a program called Quitworks, which aims to raise public awareness and provide resources to practitioners to help families quit smoking.

As the new policy statement indicates, there are many ways for pediatricians to make a difference.

“It is easier for most physicians to speak out when they have facts and policy to present,” Dr. Allen said. “We can use our voice in many ways, including through news media, legislative testimony and by contacting elected and appointed officials, by speaking with parents and student groups — anything we can imagine.”

AAP resources

If your chapter wants to get more involved in tobacco prevention and control initiatives, the following AAP resources and grant opportunities can support you.

AAP Julius B. Richmond Center of Excellence

The AAP Richmond Center houses the tobacco-control activities at the Academy. Visit to find:

* funding opportunities (see sidebar);
* Clinical Effort Against Secondhand Smoke Exposure implementation modules, a step-by-step guide to establish systematic screening for tobacco and secondhand smoke in practice;
* Smoke Free Homes Best Practices Training resources: PowerPoint presentations and materials to develop more effective counseling techniques;
* Protecting Children From Secondhand Smoke & Tobacco: A Pediatric Curriculum Guide for use in residency training;
* Chapter State Resource Map with links to state-specific information on tobacco and secondhand smoke, including data and reports, advocacy information, and local contacts and coalitions.

For more information, call 800-433-9016, ext. 4264, or e-mail [email protected].

Grants database

The AAP Division of Community-based Initiatives provides support to pediatricians to develop and implement community programs for children and their families. You can search the grants database for community projects related to tobacco and other topics. Various funding opportunities exist as well, including the Leonard P. Rome CATCH Visiting Professorships Program and CATCH Planning, Implementation and Resident Grants.


State government affairs consultation

The AAP Division of State Government Affairs provides consultation on state legislative and regulatory activities and can assist AAP chapters and members with tobacco-control issues and strategies. The division also provides resources to support chapters and members in being effective advocates.

Call 800-433-9016, ext. 7799, e-mail [email protected] or visit

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