Counseling youth in tobacco-use prevention: determinants of clinician compliance.
OBJECTIVE
The rate and determinants of tobacco prevention and cessation counseling to youth were examined for orthodontists participating in a controlled trial to decrease the incidence of tobacco use among adolescents.


METHODS
A cross-sectional interview design in private practice offices throughout Southern California was used. The survey was completed with 126 (82%) orthodontists. Clinicians randomly assigned to the experimental group (N = 77) received a 1.5 h workshop, anti-tobacco materials, reimbursement for provision of anti-tobacco prescriptions, and quarterly checkup visits. Control group clinicians (N = 77) did not receive training, materials, or visits.


RESULTS
Experimental group clinicians talked to more adolescent nonsmokers about never beginning tobacco use than did control group clinicians (P < 0.05). Experimental group clinicians talked to more adolescent tobacco users than did control group clinicians; however, the difference was not statistically significant. Content and determinants of counseling were affected by participation in the intervention.


CONCLUSIONS
Though training and support increased prevention and cessation counseling, absolute rates remained less than optimal. Social learning factors were associated with prevention and cessation counseling.
Graduate School of Public Health, San Diego State University, San Diego, 92123, California, USA.
S
S
Russos
K
K
Keating
M F
MF
Hovell
J A
JA
Jones
D J
DJ
Slymen
C R
CR
Hofstetter
B
B
Rubin
T
T
Morrison
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002140:California; D016009:Chi-Square Distribution; D002648:Child; D003376:Counseling / Q000193:education / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006293:Health Promotion / Q000379:methods / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009970:Orthodontics / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011364:Professional Practice / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012044:Regression Analysis; D012907:Smoking / Q000628:therapy; D000074606:Smoking Prevention; D014029:Tobacco Use Disorder / Q000517:prevention & control* / Q000628:therapy