State-of-the-Art Office-Based Interventions to Eliminate Youth Tobacco Use: The Past Decade

Abstract

Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a \u22state-of-the-art\u22 article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco

Secondhand Smoke Exposure and Pediatric Healthcare Visits and Hospitalizations

“…Though routine screening in the inpatient setting is feasible 46,47 and caregivers are willing to receive smoking-cessation counseling while their child is hospitalized, 48 few hospitals currently have standardized system supports (e.g., a mandatory child SHSe question during admission) for healthcare professionals to screen and intervene with caregivers about their smoking behaviors. Strengthening policies and procedures of healthcare system supports, such as clinical decision support system use and implementation of evidence based-guidelines, 49,50 may increase practitioners’ rates of engaging caregivers in meaningful SHSe reduction discussions to reduce their child’s SHSe. 43 …”

Smoking Cessation in Adolescents: targeted approaches that work

“…Thus, the clear message of this study was that training paediatricians in brief intervention skills, motivational interviewing and relapse prevention can increase the use of 5A's brief intervention in clinical practice, potentially increasing quit attempts in adolescents who smoke. Clinics actively engaging in providing smoking cessation interventions routinely to both adolescents and parents who are smokers and understanding the difference in treating tobacco dependence in youth are supported and encouraged [103].…”

White matter development and tobacco smoking in young adults: A systematic review with recommendations for future research

“…Despite significant advancements in treatments for smoking cessation (Cahill et al, 2013; Morean et al, 2015; Pbert et al, 2015), tobacco smoking remains a significant public health concern, with the prevalence of past-year tobacco use among US citizens over the age of 12 estimated at 25.5%, equating to 66.9 million individuals (SAMHSA, 2014). …”