title: Adolescent smokers seen in general practice: health, lifestyle, physical measurements, and response to antismoking advice.
abstract: OBJECTIVE
  To compare physical, lifestyle, and health characteristics of adolescent smokers and non-smokers and their initial response to anti-smoking counselling.
  
  
  METHODS
  Adolescents aged 13, 15, and 17 years were identified from age-sex registers and invited by letter for a general practice health check.
  
  
  METHODS
  Three general practices in the MRC general practice research framework.
  
  
  METHODS
  Blood pressure, body mass index, saliva cotinine concentration, peak flow rate, alcohol consumption, exercise, duration of sleep, and stated persistent health problems.
  
  
  RESULTS
  73% of the adolescents (491) attended for the health check. A total of 68 (14%) were regular smokers. By age 17 those who smoked regularly had a significantly lower systolic blood pressure than those who had never smoked regularly (by 6 mm Hg; p = 0.025) despite a significantly higher body mass index (by 1.5; p <0.001) [corrected]. Cotinine concentrations increased with smoking exposure, from 0.7 ng/ml when no family member smoked to 155 ng/ml in active smokers of six or more cigarettes a week. Significantly more regular smokers than never regular smokers drank greater than or equal to 8 g alcohol a day (chi 2 = 15.2 adjusted for age and sex p less than 0.001); regular smokers exercised less (1.0 hrs/week in boys and 0.8 hrs/week in girls v 3.4 hrs/week in boys and 2.2 hrs/week in girls; p less than 0.001) and slept less (8.0 hrs/night v 8.5 hrs/night at age 17; p less than 0.005). Persistent health problems, mostly asthma or allergic symptoms, were reported by 25% (17/68) of the smokers and 16% (60/381) of the non-smokers. Of the smokers given counselling, 60% (26/43) made an agreement with the practice doctor or nurse to give up smoking.
  
  
  CONCLUSIONS
  General practice is an appropriate setting for adolescents to receive advice on healthy lifestyle, which should not focus solely on smoking.
authors.affiliation: MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Harrow, Middlesex.
authors.forename: J
authors.initials: J
authors.lastname: Townsend
authors.forename: H
authors.initials: H
authors.lastname: Wilkes
authors.forename: A
authors.initials: A
authors.lastname: Haines
authors.forename: M
authors.initials: M
authors.lastname: Jarvis
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking; D001249:Asthma / Q000209:etiology; D001794:Blood Pressure; D001835:Body Weight; D003367:Cotinine / Q000032:analysis; D003376:Counseling; D015444:Exercise; D005194:Family Practice; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D012463:Saliva / Q000737:chemistry; D012890:Sleep; D000074606:Smoking Prevention; D006113:United Kingdom
chemical_list: D003367:Cotinine