The Clean Air for Healthy Children & Families program is a smoking cessation counseling training program. It is targeted towards health care professionals who care for pregnant women, mothers, care givers of young children, families, teens and others. Those that receive Clean Air training will learn a brief smoke smoking cessation counseling intervention the 5 A's. The five A's are a brief cessation method that clinicians may use with tobacco users or recent quitters of any age, including those who are not interested in quitting, tobacco users who are interested but not ready, and those who are ready to quit.  Clean Air teaches the office team to: Ask about tobacco use at every patient visit; Advise the tobacco user to quit in a clear, strong and personalized manner; Assess the tobacco user's willingness to make a quit attempt; Assist in the quit attempt through counseling and/or pharmacotherapy; and, Arrange follow-up contract to monitor the patient's progress. When time is very limited the program encourages providers to use the 2A's and R. This is abbreviated version of the 5A's. They are to ask about tobacco use, advise to quit then refer to the Quitline and or community resources.

The goals of the program are to:

• Increase the numbers of clinicians who routinely counsel smokers to quit
• Increase cessation attempts and rates by, pregnant women, mothers and caregivers of young children, teens who smoke.
• Reduce the portion of children who are regularly exposed to tobacco smoke pollution (second hand smoke) in their home 

Clean Air education, training, and technical assistance incorporates the recommendations of the 2000 United States Department of Health and Human Service's Clinical Practice Guideline (CPG): Treating Tobacco Use and Dependence.  It is appropriate for use in practice-based offices (obstetrics and gynecological, pediatric, and family practice), well baby clinics, prenatal clinics as well as ancillary family support organizations. Trainings are conducted through efforts of the Primary Contractors, Service Providers and a network of community based Clean Air trainers. 

Program Development

The Pennsylvania Chapter of the American Academy of Pediatrics (PA AAP) has administered the Clean Air for Healthy Children & Families program (Clean Air program) since 1996 through funding by the Pennsylvania Department of Health (PA DOH).  In addition, the American Cancer Society adapted the Clean Air curriculum to create their Make Yours a Fresh Start curriculum. The Clean Air program has been continuously updated to reflect the most current research on smoking cessation and recommendations by the experts in tobacco control. In 2005 PAAAP joined into a partnership with the Pennsylvania Area Health Education Center (AHEC).

Clean Air incorporates the recommendations of the following:

• The American College of Obstetricians and Gynecologists (ACOG) Education Bulletin (2005) - Smoking Cessation During Pregnancy, No. 312.
• Smoke Free Families National Partnership to Help Pregnant Smokers Quit.
• The American Academy of Pediatrics (AAP) policy - Tobacco's Toll: Implications for the Pediatrician (RE0041).
• Smoke Free Homes
• The United States Environmental Protection Agency (EPA) (2001).
• United States Department of Health and Human Services:  The Health Consequences of Smoking: A Report of the Surgeon General, 2004
• United States Department of Health and Human Services: The Health Consequences of Involuntary Exposure to Tobacco Smoke, A Report of the Surgeon General, 2006