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Primary Care Interventions to Prevent Tobacco Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement FREE

[+] Article and Author Information

The full report is titled “Primary Care Interventions to Prevent Tobacco Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 15 October 2013 issue of Annals of Internal Medicine (volume 159, pages 552-557). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.

This article was published online first at www.annals.org on 26 August 2013.


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Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.


Ann Intern Med. 2013;159(8): I-36. doi:10.7326/0003-4819-159-8-201310150-00699
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Who developed these recommendations?

The U.S. Preventive Services Task Force (USPSTF) developed these recommendations. The USPSTF is a group of health experts that reviews published research and makes recommendations about preventive health care.

What is the problem and what is known about it so far?

Tobacco use, most commonly in the form of cigarette smoking, is the leading cause of preventable death in the United States. Smoking increases a person's risk for heart disease, lung disease, dental disease, and some types of cancer. Nicotine is the addictive substance in tobacco; it can make quitting very difficult.

A person's path to daily smoking and nicotine dependence can be described in 5 stages: susceptible to smoking (never smoked), initiation (trying the first cigarette), experimentation (repeatedly trying cigarettes, may show signs of addiction), established smoking (regular smoking, likely to show signs of addiction), and nicotine dependence.

Children and adolescents are susceptible to smoking initiation and experimentation. Although it can take up to 2 years to develop nicotine addiction, some children and adolescents develop addiction more quickly. Many strategies aim to discourage people from using tobacco, including public service messages, restrictions on smoking in public, taxes and age restrictions for tobacco purchases, education, and counseling by health care providers. The USPSTF wanted to develop recommendations about whether children and adolescents should receive interventions to prevent tobacco use as part of routine primary care.

How did the USPSTF develop these recommendations?

The USPSTF reviewed published research on the effectiveness of primary care interventions on the rates of starting and stopping tobacco use in children and adolescents. It also looked for studies of the effect of these interventions on health outcomes, whether young smokers continued to smoke as adults, and the harms of these interventions.

What did the authors find?

The USPSTF found that interventions, such as face-to-face or telephone interactions with a health care provider, written materials, and computer applications, can lower the risk for smoking initiation in school-aged children and adolescents. The USPSTF believes that the harms of such interventions are small or none.

What does the USPSTF recommend that patients and doctors do?

The USPSTF recommends that primary care clinicians provide interventions, including education or brief counseling, to prevent school-aged children and adolescents from ever trying a first cigarette.

What are the cautions related to these recommendations?

These recommendations do not address what primary care clinicians should do for children and adolescents who are already regular smokers.

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