Delivery of smoking prevention and cessation services to adolescents.
OBJECTIVE
To describe the delivery of smoking prevention and cessation screening and counseling practices to adolescents and to examine the effect of physician specialty, sex, practice characteristics, and familiarity with preventive care guidelines on the delivery of smoking cessation counseling services.


METHODS
Cross-sectional self-reported survey of pediatricians and family physicians in 3 New York metropolitan statistical areas who had seen 1 or more adolescents for well care within the past 6 months.


RESULTS
Of 564 eligible physicians, 371 (66%) responded. Physicians reported asking most adolescents about smoking (91%) but were less likely to ask about peer smoking use (41%) or smokeless tobacco use (32%). Similarly, they reported assessing motivation to quit for 81% of smokers, but less often helped set quit dates (34%) or scheduled follow-up visits (28%). Family physicians were more likely to provide more effective smoking cessation interactions than pediatricians (mean smoking counseling performance score, 61 vs. 53; P<.001). Family physicians were also more likely to be familiar with National Cancer Institute guidelines than pediatricians (48% vs. 27%; P<.001). Female physicians reported having spent more time with their last adolescent patient (mean, 26 vs 21 minutes; P<.001) and more often spent time alone with adolescent patients (85% vs. 76% of visits; P<.001) than did male physicians. In multivariate modeling, specialty, familiarity with National Cancer Institute guidelines, time spent, and confidentiality factors were associated with better smoking counseling performance.


CONCLUSIONS
Familiarity with smoking cessation guidelines and physician's specialty and practice style with adolescents are associated with better delivery of tobacco cessation counseling to adolescents.
Klein
J D
JD
Division of Adolescent Medicine, Department of Pediatrics, University of Rochester, Box 690, 601 Elmwood Ave, Rochester, NY 14642, USA. jonathan_klein@urmc.rochester.edu
Levine
L J
LJ
Allan
M J
MJ
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000592:standards; D000704:Analysis of Variance; D003376:Counseling / Q000458:organization & administration* / Q000592:standards; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009518:New York; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016540:Smoking Cessation; D000074606:Smoking Prevention