Physician Communication Regarding Smoking and Adolescent Tobacco Use

Physician advice increases quit rates 1% to 3% above unassisted quit rates among adults, an increase sufficient to be ranked as a high-priority, evidence-based preventive service. However, there is little research on the potential impact of physician advice on adoles- cent smoking. OBJECTIVE: The purpose of this study was to examine the association between recalled physician communication and adolescents' attitudes toward smoking, knowledge about smoking, intentions to smoke, to- bacco use, and quitting behaviors. METHODS: This study was a retrospective observational study of 5154 students (82.9% black, 17.1% white) from an urban, mid-South school system. Outcome variables included adolescents' self-rated attitudes toward smoking, knowledge about smoking, intentions to smoke, to- bacco use, and quitting behaviors. RESULTS: Physician advice and the combination of screening and ad- vice were associated with healthier attitudes about smoking. Physician screening and advice were also associated with a more accurate knowledge regarding tobacco-related damage. Among current smok- ers, recalled physician advice was also associated with reduced inten- tions to smoke in 5 years. Importantly, advised teens were more likely to plan to quit smoking in 6 months. Furthermore, teens who were screened by their physician reported significantly more quit attempts than those who were neither screened nor advised (P.007). CONCLUSIONS: Physician's tobacco-related interactions with adoles- cents seemed to positively impact their attitudes, knowledge, inten- tions to smoke, and quitting behaviors. Brief physician interventions have the potential to be a key intervention on a public health level through the prevention, cessation, and reduction of smoking and smoking-related disease. Pediatrics 2011;127:e1368-e1374