Susan C. Walley, MD, CTTS, FAAP, Associate Professor of Pediatrics, University of Alabama at Birmingham

Speaker Disclosure

Susan Walley, MD

  • Will discuss any commercial products or services

  • Does not intend to discuss non-FDA approved uses of products/providers of services

  • Does not have a relevant financial relationship with any commercial interests

Commercial Support

This activity receives no commercial support


Tobacco smoke exposure is one of the most common causes of pediatric illness and it is totally preventable.  Tobacco smoke - including secondhand smoke - is one of the most common asthma triggers. Secondhand smoke is a mixture of gases and fine particles that includes:

  • Smoke from a burning cigarette, cigar, or pipe tip

  • Smoke that has been exhaled (breathed out) by someone who smokes

  • Secondhand smoke contains more than 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer.

Learning Objectives

Upon completion of this internet enduring material activity participants will be able to:

  • Review the impact of tobacco exposure on the health of children

  • Discuss evidence-based smoking cessations interventions

  • Review implementation of pediatric inpatient smoking cessation interventions

  • Provide overview of electronic cigarettes/vape devices and health impacts

Please review the information below and follow the instructions in order to view the training, complete the online evaluation form, and successfully pass the online post-test, which will automatically submit for CME credit(s).

Disclaimer Statement

This Internet Enduring Material activity does not necessarily reflect the views, opinions, policies or procedures of the Alabama Chapter-American Academy of Pediatrics, Children’s of Alabama, or its staff or representatives.  Alabama Child Health Improvement Alliance cannot and does not assume any responsibility for the use, misuse or misapplication of any information.

Designation Statement

Children’s of Alabama designates this enduring material for a maximum of .75 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accreditation Statement 

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Children’s of Alabama and the Alabama Child Health Improvement Alliance.  Children’s of Alabama is accredited by the Medical Association of the State of Alabama to provide continuing medical education for physicians.

Enduring Materials Information

Formats Available: Streaming*

On-Demand Release Date: 11/14/2017

On-Demand Expiration Date: 11/14/2020

Please note that effective July 1, 2011, enduring materials are required to provide an assessment of the learner that measures achievement of the educational purpose and/or objectives of the activity.  Upon completion of this activity, you will be directed to the post-test.  To receive your CME certificate, you must score a minimum of 75% on the test.


All three steps are required:

Video Training: Thinking Outside the (Cigarette) Box: Implementing Tobacco Dependence Treatment in Pediatric Settings, Susan C. Walley, MD, CTTS, FAAP, Associate Professor of Pediatrics, University of Alabama at Birmingham. Video Time: 46.45 minutes

Click HERE to access the video.  It is recommended that you access the PowerPoint presentation handout HERE to review as you watch the video.  You will be instructed to return here to access the post-test and CME activity evaluation.

2.  Post-Test

To take test, choose physician post-test or non-physician posttest (test is the same but CME certificate is different).  You must click through and complete entire test (75% pass rate) in order for your test results to be submitted for CME credit AND certification.  On the last screen you will see your test score and if passing, will be prompted to download your CME certificate.

3.  Evaluation

Click HERE to take/submit CME activity evaluation.

Thinking outside the (Cigarette) Box: Implementing Tobacco Dependence Treatment in Pediatric Settings Bibliography

Vital Signs: Nonsmokers' Exposure to Secondhand Smoke --- United States, 1999—2008. Morbidity and Mortality Weekly Report (MMWR). September 10, 2010 / 59(35); 1141-1146

Braun JM, Froehlich TE, Daniels JL, et al. Association of environmental toxicants and conduct disorder in U.S. children: NHANES 2001-2004. Environmental Health Perspectives. Jul 2008; 116(7):956-962.

Alberg AJ, Chen JC, Zhao H, Hoffman SC, Comstock GW, Helzlsouer KJ. Household exposure to passive cigarette smoking and serum micronutrient concentrations. The American journal of clinical nutrition. 2000; 72(6):1576-1582.

Hall, N., Friebely, J., Ossip, D., Winickoff, J. (2009). Addressing Family Smoking in Child Health Care Settings. Journal of Clinical Outcomes Management, 16(8), 367–73.

Balfour DJ & Fagerström KO. Pharmacol Ther 1996; 72:51–81

 Leung GM, Ho L-M, Lam T-H. Secondhand smoke exposure, smoking hygiene, and hospitalization in the first 18 months of life. Archives of pediatrics & adolescent medicine. 2004; 158(7):687-693.

Multiple studies showing TSE increases risk of more severe bronchiolitis with lower oxygen levels, 3 higher rates of hospitalization,4 and more severe disease.5,6   

  • Bradley JP, Bacharier LB, Bonfiglio J, Schechtman KB, Strunk R, Storch G, Castro M. Severity of respiratory syncytial virus bronchiolitis is affected by cigarette smoke exposure and atopy. Pediatrics. 2005; 115(1):e7-14.

  • Al-Shawwa B, Al-Huniti N, Weinberger M, Abu-Hasan M. Clinical and therapeutic variables influencing hospitalization for bronchiolitis in a community-based paediatric group practice. Primary Care Respiratory Journal. 2007; 16 (2): 93-97.

  • Law BJ, Carbonell-Estrany X, Simoes EA. An update on respiratory syncytial virus epidemiology: a developed country perspective. Respi Med 2002; 96 (Suppl B): S1-7.

  • Semple MG, Taylor-Robinson DC, Lane S, Smyth RL. Household Tobacco Smoke and Admission Weight Predict Severe Bronchiolitis in Infants Independent of Deprivation: Prospective Cohort Study. 2011; PLoS ONE 6(7): e22425.

Asthma readmissions Kahn Pediatrics 2014

Influenza Wilson J Pediatrics 2013