Primary Care Interventions to Prevent Tobacco Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement*

Moyer, Virginia A.; Lefevre, Michael; Siu, Albert L.; Baumann, Linda C.; Bibbins‐Domingo, Kirsten; Curry, Susan J.; Ebell, Mark H.; Flores, Glenn; García, Francisco; Cantu, Adelita G.; Grossman, David C.; Herzstein, Jessica; Nicholson, Wanda K; Owens, Douglas K; Phillips, William R.; Pignone, Michael

doi:10.7326/0003-4819-159-8-201310150-00697

Cited by 20 publications

(18 citation statements)

References 5 publications

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“…3,10 Accordingly, a number of national guidelines recommend that health care providers offer adolescents tobacco use screening, education, and counseling during theirannual visit. 1,11,12 A majority of practice guidelines recommend that clinicians ask pediatric and adolescent patients about tobacco use, provide advice to abstain from tobacco use, and provide counseling interventions to help those who use tobacco to quit. 1,7,12,13 Tobacco cessation medications are not currently recommended for use in adolescents because of insufficient evidence for or against their effectiveness.…”

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confidence: 99%

“…1,11,12 A majority of practice guidelines recommend that clinicians ask pediatric and adolescent patients about tobacco use, provide advice to abstain from tobacco use, and provide counseling interventions to help those who use tobacco to quit. 1,7,12,13 Tobacco cessation medications are not currently recommended for use in adolescents because of insufficient evidence for or against their effectiveness. 1 Data from the 2000 National Youth Tobacco Survey (NYTS) indicate that only one-third of adolescents who visited a physicianin the previousyear reported receiving preventive advice about the dangers of tobacco, and only 16.4% of adolescentswho smokedinthepastyear reported receiving advice from a physician to quit 14 ; those who were established smokers were significantly more likely to receive both preventive and cessation advice.…”

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confidence: 99%

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Health Care Provider Advice for Adolescent Tobacco Use: Results From the 2011 National Youth Tobacco Survey

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Cigarette smoking during adolescence causes significant health problems. Health care providers play an important role in promoting tobacco use abstinence among adolescents, but recent data on the prevalence of provider screening and advice to adolescents are lacking. WHAT THIS STUDY ADDS:This study uses nationally representative surveillance data to provide current estimates of self-reported receipt of health professional screening and advice about tobacco use among US adolescents. Cessation behaviors and correlates of past-year quit attempts among smokers were also explored. abstract BACKGROUND: Health care providers play an important role in promoting tobacco use abstinence among adolescents. This study aimed to provide nationally representative data on the prevalence of provider tobacco use screening and advice delivered to adolescents. Cessation behaviors and correlates of past year quit attempts among current smokers are also explored. METHODS:Data came from the 2011 National Youth Tobacco Survey, a nationally representative school-based survey of adolescents in grades 6 through 12 (n = 18 385). Provider screening and advice were assessed by smoking status and demographic characteristics. Logistic regression was used to assess the association between advice and past year quit attempt. RESULTS:The overall prevalence of current tobacco use was 16.6%; 10.8% were current cigarette smokers (3.6% were established smokers, 7.2% were nonestablished smokers); 17.3% were former smokers; and 71.9% were never smokers (22.6% high susceptibility, 77.4% low susceptibility). Among all respondents, the prevalence of being asked about tobacco use by a health care provider was 32.2%; the prevalence of being advised to quit or avoid tobacco was 31.4%. Established smokers were more likely than other groups to report provider assessment of tobacco use and advice. Receipt of advice was associated with a higher adjusted odds of having made a past year quit attempt (odds ratio: 1.47, 95% confidence interval: 1.18-1.82).

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confidence: 99%

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confidence: 99%

Health Care Provider Advice for Adolescent Tobacco Use: Results From the 2011 National Youth Tobacco Survey

et al. 2014

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“…26 Nearly a half-billion dollars is spent annually on anti-tobacco advertising. 27 Yet whether adolescents nationwide perceive light and intermittent smoking to be less harmful than heavier forms of smoking has not been assessed.…”

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confidence: 99%

Adolescents’ Perceptions of Light and Intermittent Smoking in the United States

Amrock

Weitzman

2015

Pediatrics

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BACKGROUND: Light smoking, consuming a few cigarettes daily, and intermittent, or nondaily, smoking patterns are increasingly common but carry health risks comparable to heavier smoking patterns. Nearly all smokers begin smoking as adolescents, who are at risk for developing these smoking patterns. Previous research suggests that smokers underestimate the risks associated with smoking. The extent to which adolescents perceive light and intermittent smoking as harmful has not been previously assessed.METHODS: Data from 24 658 US adolescents sampled by the 2012 National Youth Tobacco Survey, a national, school-based, cross-sectional survey, were examined. Cross-tabulations and multivariate ordered probit regression models were constructed to describe correlates of US adolescents' perception of light and intermittent smoking.RESULTS: Although most adolescents (88.0%; 95% confidence interval [CI], 87.2% to 88.8%) reported beliefs that a heavier smoking pattern is very harmful, only 64.3% (95% CI; 63.2% to 65.3%) and 33.3% (95% CI; 32.0% to 34.6%) reported that light and intermittent smoking, respectively, are very harmful. Conversely, nearly one-quarter of US adolescents believed intermittent smoking causes little or no harm. Males, younger adolescents, Hispanics, and non-Hispanic blacks were more likely than their peers to view light and intermittent smoking patterns as less harmful. Those who were already light or intermittent smokers, those who used other tobacco products, and those who had a family member who used tobacco were also less likely to view their smoking patterns as harmful.CONCLUSIONS: Misconceptions about the safety of light and intermittent smoking are widespread among US adolescents. Significant public health attention is needed to redress these misperceptions.WHAT'S KNOWN ON THIS SUBJECT: Light and intermittent smoking are harmful, but increasingly common, smoking patterns. It is unknown how adolescents perceive these smoking patterns, and whether these views differ by sociodemographic characteristics, and exposure to and use of tobacco.WHAT THIS STUDY ADDS: US adolescents perceive light and intermittent smoking as significantly less dangerous than heavier smoking. One in 4 adolescents believes intermittent smoking causes little to no harm. Perceptions of relative safety were common among smokers.

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“…109 The USPSTF report concluded, "The USPSTF found adequate evidence that behavioral counseling interventions, such as face-to-face or phone interaction with a health care provider, print materials, and computer applications, can reduce the risk for smoking initiation in school-aged children and adolescents." A meta-analysis of behaviorally based interventions to prevent tobacco use initiation found 10 relevant trials with a pooled risk ratio of 0.81 (95% CI: 0.70-0.93).…”

Section: Recommendation Strength: Strong Recommendationmentioning

confidence: 99%

Protecting Children From Tobacco, Nicotine, and Tobacco Smoke

Farber¹,

Groner²,

Walley³

et al. 2015

Pediatrics

209

121

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This technical report serves to provide the evidence base for the American Academy of Pediatrics’ policy statements “Clinical Practice Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke” and “Public Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke.” Tobacco use and involuntary exposure are major preventable causes of morbidity and premature mortality in adults and children. Tobacco dependence almost always starts in childhood or adolescence. Electronic nicotine delivery systems are rapidly gaining popularity among youth, and their significant harms are being documented. In utero tobacco smoke exposure, in addition to increasing the risk of preterm birth, low birth weight, stillbirth, placental abruption, and sudden infant death, has been found to increase the risk of obesity and neurodevelopmental disorders. Actions by pediatricians can help to reduce children’s risk of developing tobacco dependence and reduce children’s involuntary tobacco smoke exposure. Public policy actions to protect children from tobacco are essential to reduce the toll that the tobacco epidemic takes on our children.

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Primary Care Interventions to Prevent Tobacco Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement*

Abstract: The USPSTF recommends that primary care clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use in school-aged children and adolescents.

Cited by 20 publications

References 5 publications

Health Care Provider Advice for Adolescent Tobacco Use: Results From the 2011 National Youth Tobacco Survey

Health Care Provider Advice for Adolescent Tobacco Use: Results From the 2011 National Youth Tobacco Survey

Adolescents’ Perceptions of Light and Intermittent Smoking in the United States

Protecting Children From Tobacco, Nicotine, and Tobacco Smoke

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