Should you ask a 3-6 year old about exposure to tobacco, alcohol, and drugs?

Should you ask a 3-6 year old about exposure to tobacco, alcohol, and drugs?

• A. Yes, inquire about exposure
• B. No, do not ask about exposure
• C. Only ask if there are visible signs
• D. Only ask if the child mentions it

Answer: (A)

Screening for environmental risks is an essential part of pediatric preventive care. For a 3- to 6-year-old, you should routinely ask caregivers about exposure to tobacco, alcohol, and drugs because secondhand smoke and caregiver substance use can harm a child’s health and development even when there are no obvious signs. Early identification allows you to provide anticipatory guidance, support for reducing exposure, and referrals to resources, which can prevent respiratory problems, behavior issues, and other complications. Waiting for visible signs or for the child to mention exposure is unreliable, since young children may not recognize or communicate these risks. So the best approach is to inquire about exposure in a nonjudgmental, universal way, phrasing questions like, “Does anyone in the home smoke or use alcohol or drugs?”

Screening for environmental risks is an essential part of pediatric preventive care. For a 3- to 6-year-old, you should routinely ask caregivers about exposure to tobacco, alcohol, and drugs because secondhand smoke and caregiver substance use can harm a child’s health and development even when there are no obvious signs. Early identification allows you to provide anticipatory guidance, support for reducing exposure, and referrals to resources, which can prevent respiratory problems, behavior issues, and other complications. Waiting for visible signs or for the child to mention exposure is unreliable, since young children may not recognize or communicate these risks. So the best approach is to inquire about exposure in a nonjudgmental, universal way, phrasing questions like, “Does anyone in the home smoke or use alcohol or drugs?”