ArticleFrontiers in public health2026
Formal tobacco-control training and thirdhand smoke counseling practices among pediatric nurses in China: a cross-sectional study of cognitive and implementation factors.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Thirdhand smoke (THS) exposure poses significant health risks to children, yet pediatric healthcare providers' capacity to deliver evidence-based counseling remains poorly characterized, particularly in high-burden settings. This study examined THS counseling practices among pediatric nurses in China, with particular emphasis on the relative contributions of formal tobacco-control training, cognitive factors, and implementation context. Methods: We conducted a cross-sectional survey of pediatric nurses at The Third Xiangya Hospital of Central South University, Changsha, China. Data were collected between February 2022 and October 2025 (response rate: 83.7%). Participants completed validated instruments assessing THS knowledge, attitudes, self-efficacy, counseling practices, implementation factors, and clinical performance using standardized vignettes. Sequential multivariable linear regression was used to identify independent predictors of counseling practices. Results: Among 633 pediatric nurses (mean age 32.1 ± 5.7 years; 91.6% female), 248 (39.2%) had received formal tobacco-control training in the preceding 24 months. Training was the strongest correlate of counseling practices ( Conclusion: Training is associated with more frequent THS counseling, yet misconceptions persist and disadvantaged families receive lower-quality care. Prospective trials are needed to test whether skills-based training redesign and workflow-embedded decision supports can translate this association into equitable improvements in child health protection.
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