More information on adolescent use of alternative tobacco products is needed. Current cigarette use declined 3.4% annually over 2004-2009 for the NYTS 14- to 17-year-old population, but this cohort's use of alternative tobacco products was unchanged. The number of adolescents aged 14-17 who did not smoke cigarettes but used alternative tobacco products increased 5.9% per year over the same period. Current surveillance measures need to be expanded in order to gain a more comprehensive understanding of adolescent alternative tobacco use.

Purpose:The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes). We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized.Methods:A statewide sample of Florida primary care medical residents (n = 61) and practicing physicians (n = 53) completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups.Results:Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes (P = .0003). Medical residents were more likely to receive information about e-cigarettes from colleagues (P = .0001). No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations.Conclusions:Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.

State-supported programs providing loans and scholarships in exchange for service in underserved areas provide an important source of financial support for medical students while encouraging them to select careers in primary care. The purpose of this research was to seek a better understanding of these often unheralded but important state sources of support, and learn if they have continued to grow in the twenty-first century. Administrative data were obtained on statesupported programs operating in 2008 that provided financial support to students, resident or practicing physicians, physician assistants, nurse practitioners, certified nurse midwives, dentists, and licensed mental healthcare providers in exchange for service in an underserved area. The authors identified numbers, types of state-supported programs, program workforce strength, and features of state programs. In 2008, 75 state programs, operating in 37 states, collectively had 5113 program participants under contract. Loan repayment programs (n = 42, 56%) were the most common type of state-supported programs. Practitioners signed initial contracts in 2008 totaled 1173, with more non-physicians (n = 681, 58%) signing initial contracts than physicians (n = 492, 42%). Additionally, 2803 practitioners were serving in programs in 2008. Field placement was also slightly greater among non-physicians in 2008 (n = 1433, 51%) than physicians (n = 1370, 49%). State support-for-service programs remains an important source of financial assistance for those willing to make service commitments in underserved areas. Moreover, these programs continue to increase in size, even amidst the economic malaise, and provide an obligated primary care workforce in underserved areas. K. W. Geletko et al.1995

In the absence of meaningful health reform, Florida implemented a volunteer health care program to strengthen the existing safety net. Since program implementation in 1992, over $1 billion of services have been provided to uninsured and underserved populations. Currently, over 20,000 volunteers participate statewide. Key incentives for provider participation have been an organized framework for volunteering and liability protection through state-sponsored sovereign immunity. Volunteerism, although not a solution to the health care crisis, serves as a valuable adjunct pending full-scale health care reform.