SHORT REPORT
Physician tobacco screening and advice to quit among U.S. adolescents – National Survey on Drug Use and Health, 2013
 
More details
Hide details
1
Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, USA
2
Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, USA
3
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
Publish date: 2017-01-10
 
Tob. Induc. Dis. 2017;15(January):2
KEYWORDS:
ABSTRACT:
Background:
Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued smoking. Physician screening for tobacco use increases the odds of physicians intervening with patients who smoke; However, without appropriate follow-through by the physician, screening for tobacco use is not enough to significantly increase cessation rates. Given the critical phase of development adolescence poses in tobacco use and evidence that physician intervention improves adult cessation efforts, we sought to examine physician tobacco use screening and advice to quit among adolescents (12–17 years).

Methods:
Using data from the 2013 National Survey on Drug Use and Health (NSDUH), we examined the prevalence and correlates of tobacco use screening in adolescent respondents who reported visiting their physician within the past year (N = 12,798). Multivariable logistic regression analyses explored the relationship between tobacco use screening and physician advice to quit in a sub-set of the sample who reported on physician advice to quit (n = 1,868), controlling for sociodemographics, cigarette use, and substance use and screening.

Results:
Only 49% of adolescents who visited a physician within the past year reported being screened for tobacco use. Adolescents who were screened by their physician were predominantly female (56.6%), White (60.1%), in late adolescence (83.0%), and covered by private health insurance (63.8%). Screening for tobacco use was highly correlated with physician advice to quit smoking, controlling for sociodemographic characteristics and cigarette use; this relationship was attenuated, but remained significant, after screening for alcohol and marijuana were added to the model. Hispanic adolescents were significantly less likely to receive physician advice to quit in all multivariable models.

Conclusions:
Our findings suggest missed opportunities for youth tobacco use prevention and cessation efforts in the clinical setting. Further research is needed to better facilitate an open dialogue on tobacco use between physicians and their adolescent patients.

CORRESPONDING AUTHOR:
Lauren Collins   
Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC, USA
 
REFERENCES (27):
1. Sussman S. A lifespan developmental-stage approach to tobacco and other drug abuse prevention. ISRN Addict. 2013;2013:745783. doi:10.1155/2013/745783.
2. Graber JA, Brooks-Gunn J. Developmental transitions: linking human development with tobacco prevention research. Nicotine Tob Res. 1999;1 Suppl 1:S73–7.
3. Abuse S, Administration MHS. Results from the 2013 national survey on drug use and health: summary of national findings. Rockville: Substance Abuse and Mental Health Services Administration; 2014.
4. Dierker L, Hedeker D, Rose J, et al. Early emerging nicotine dependence symptoms in adolescence predict daily smoking in young adulthood. Drug Alcohol Depend. 2015;151:267–71. doi:10.1016/j.drugalcdep.2015.03.009.
5. Dierker L, Mermelstein R. Early emerging nicotine-dependence symptoms: a signal of propensity for chronic smoking behavior in adolescents. J Pediatr. 2010;156:818–22. doi:10.1016/j.jpeds.2009.11.044.
6. Dierker L, Swendsen J, Rose J, et al. Transitions to regular smoking and nicotine dependence in the Adolescent National Comorbidity Survey (NCS-A). Ann Behav Med. 2012;43:394–401. doi:10.1007/s12160-011-9330-9.
7. Doubeni CA, Reed G, Difranza JR. Early course of nicotine dependence in adolescent smokers. Pediatrics. 2010;125:1127–33. doi:10.1542/peds.2009-0238.
8. Kann L, Kinchen S, Shanklin SL, et al. Youth risk behavior surveillance-United States, 2013. MMWR Suppl. 2014;63(4):1–168.
9. Simon P, Kong G, Cavallo DA, et al. Update of adolescent smoking cessation interventions: 2009–2014. Curr Addict Rep. 2015;2:15–23. doi:10.1007/s40429-015-0040-4.
10. Stanton A, Grimshaw G. Tobacco cessation interventions for young people. Cochrane Database Syst Rev. 2013;8:CD003289. doi:10.1002/14651858.CD003289.pub5.
11. Kottke TE, Battista RN, DeFriese GH, et al. Attributes of successful smoking cessation interventions in medical practice. A meta-analysis of 39 controlled trials. JAMA. 1988;259:2883–9.
12. Fiore M, Jaen C, Baker T, et al. Treating tobacco use and dependence: 2008 update. Rockville: U.S. Department of Health and Human Services. Public Health Service; 2008.
13. Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2008:CD000165. DOI: 10.1002/14651858.CD000165.pub3.
14. Schauer GL, Agaku IT, King BA, et al. Health care provider advice for adolescent tobacco use: results from the 2011 National Youth Tobacco Survey. Pediatrics. 2014;134:446–55. doi:10.1542/peds.2014-0458.
15. Hum AM, Robinson LA, Jackson AA, et al. Physician communication regarding smoking and adolescent tobacco use. Pediatrics. 2011;127:e1368–74. doi:10.1542/peds.2010-1195.
16. Devoe JE, Baez A, Angier H, et al. Insurance + access not equal to health care: typology of barriers to health care access for low-income families. Ann Fam Med. 2007;5:511–8. doi:10.1370/afm.748.
17. Newacheck PW, Hughes DC, Stoddard JJ. Children’s access to primary care: differences by race, income, and insurance status. Pediatrics. 1996;97:26–32.
18. National Institute on Drug Abuse. Resource Guide: Screening for Drug Use in General Medical Settings. Available at: https://www.drugabuse.gov/publ... Accessed 10 Nov 2016.
19. Tong EK, Strouse R, Hall J, et al. National survey of U.S. health professionals’ smoking prevalence, cessation practices, and beliefs. Nicotine Tob Res. 2010;12:724–33. 10.1093/ntr/ntq071.
20. Klein JD, Allan MJ, Elster AB, et al. Improving adolescent preventive care in community health centers. Pediatrics. 2001;107:318–27.
21. Klein JD, Wilson KM. Delivering quality care: adolescents’ discussion of health risks with their providers. J Adolesc Health. 2002;30:190–5.
22. Nugent CN, Schoenborn CA, Vahratian A. Discussions between health care providers and their patients who smoke cigarettes. NCHS data brief, no 174. Hyattsville: National Center for Health Statistics; 2014.
23. Browning KK, Ferketich AK, Salsberry PJ, et al. Socioeconomic disparity in provider-delivered assistance to quit smoking. Nicotine Tob Res. 2008;10:55–61. doi:10.1080/14622200701704905.
24. Cokkinides VE, Halpern MT, Barbeau EM, et al. Racial and ethnic disparities in smoking-cessation interventions: analysis of the 2005 National Health Interview Survey. Am J Prev Med. 2008;34:404–12. doi:10.1016/j.amepre.2008.02.003.
25. Vogt F, Hall S, Marteau TM. General practitioners’ and family physicians’ negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review. Addiction. 2005;100:1423–31. doi:10.1111/j.1360-0443.2005.01221.x.
26. Horvath KJ, Eastman M, Prosser R, et al. Addressing smoking during medical visits: patients with human immunodeficiency virus. Am J Prev Med. 2012;43:S214–21. doi:10.1016/j.amepre.2012.07.032.
27. Blumenthal DS. Barriers to the provision of smoking cessation services reported by clinicians in underserved communities. J Am Board Fam Med. 2007;20:272–9. doi:10.3122/jabfm.2007.03.060115.
 
CITATIONS (1):
1. Trends in Healthcare Provider Advice on Youth Tobacco Use, 2011–2015
Hongying Dai, Mark Clements
American Journal of Preventive Medicine
eISSN:1617-9625