A short, confidential questionnaire provides pediatricians with the ability to detect adolescent experimental smoking before the patient develops nicotine addiction, according to an article in the January issue of the Archives of Pediatrics & Adolescent Medicine, a member of the JAMA family of journals. Irwin Benuck, M.D., and colleagues from Northwestern University Medical School in Chicago surveyed high school students in a suburban pediatric practice to identify adolescent smokers and to characterize adolescent tobacco users. The participants answered a tobacco use questionnaire and provided a urine sample (to measure cotinine level) to validate the survey response. Of the 124 adolescents enrolled in the study, 67 percent were nonsmokers, 23 percent were experimenters and 10 percent were smokers. The survey correctly identified 92 percent of the smokers.
The researchers found that smoking frequency increased by grade level, smoking initiation occurred with peers, and compared with nonsmokers, smokers and experimenters were more likely to be older and have a majority of friends who smoked. Smokers were also more likely to have a family member who smoked. "Though the primary causes of smoking remain social, and nicotine addiction is difficult to treat, physicians remain the most trusted carriers of the antismoking message," write the authors. "Because cigarette smoking begins in early adolescence, the antismoking message should be part of health maintenance visits beginning at 10 to 11 years of age, particularly in high-risk situations in which it is known that the patient has family members who smoke, friends who smoke, or other risk factors." The authors suggest that by helping experimenters quit smoking, pediatricians can be even more involved in the national effort to stop the rising prevalence of habitual teen smoking.
According to background information cited in the study, although it has been recommended that antismoking and smoking cessation counseling be incorporated in pediatric practice, there are no recommendations for obtaining information on tobacco use from teens.
(Arch Pediatr Adolesc Med. 2001; 155:32-35)
Editor's Note: To contact Irwin Benuck, M.D., call Elizabeth Crown at 312-503-8928. This study was supported in part by the Keeshin Trust, Chicago.
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