title: State-of-the-art office-based interventions to eliminate youth tobacco use: the past decade.
abstract: Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a "state-of-the-art" article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco.
authors.affiliation: Department of Medicine; and Lori.Pbert@umassmed.edu.
authors.forename: Lori
authors.initials: L
authors.lastname: Pbert
authors.affiliation: Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas;
authors.forename: Harold
authors.initials: H
authors.lastname: Farber
authors.affiliation: Department of Prevention and Community Health, The George Washington University, Washington, District of Columbia;
authors.forename: Kimberly
authors.initials: K
authors.lastname: Horn
authors.affiliation: Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota;
authors.forename: Harry A
authors.initials: HA
authors.lastname: Lando
authors.affiliation: Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona;
authors.forename: Myra
authors.initials: M
authors.lastname: Muramoto
authors.affiliation: Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada;
authors.forename: Jennifer
authors.initials: J
authors.lastname: O'Loughlin
authors.affiliation: Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire;
authors.forename: Susanne
authors.initials: S
authors.lastname: Tanski
authors.affiliation: Department of Family Medicine and Community Health University of Massachusetts Medical School, Worcester, Massachusetts;
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wellman
authors.affiliation: Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Winickoff
authors.affiliation: Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000639:trends; D003430:Cross-Sectional Studies; D004505:Education, Nonprofessional / Q000639:trends; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects* / Q000639:trends; D006801:Humans; D011320:Primary Health Care / Q000639:trends; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000517:prevention & control; D014481:United States
chemical_list: D014028:Tobacco Smoke Pollution
keywords: adolescent; child; dependence; intervention; pediatric practice; tobacco use; youth