title: Physician Advice to Adolescents About Smoking: Who Gets Advised and Who Benefits Most?
abstract: OBJECTIVE
  The Clinical Practice Guidelines instruct physicians to ask their patients about smoking and to advise against tobacco use. Physicians are urged especially to attend to racial minorities and teens because of these groups' increased susceptibility to smoking. Research on race and physician advice against smoking has produced contradictory findings. The purpose of this study is to clarify the relationships between physician communication about tobacco, race, and smoking among adolescents.
  
  
  METHODS
  This cross-sectional retrospective study explored (1) racial differences in rates of receiving physician communication and (2) whether the relationship between physician communication and smoking among adolescents was moderated by race. Multiple measures of smoking status were used (e.g., intentions to quit, quit attempts, quits, relapse status). We used a large (N = 5,154), predominately African-American (82.9%) sample of 11th graders.
  
  
  RESULTS
  Regular smokers were more likely to be screened about smoking. African Americans were more frequently advised against tobacco than Caucasians. Among African Americans, nonsmokers were most likely to be both screened and advised; among Caucasians, regular were most likely to be screened and advised. Overall, physician intervention was associated with greater benefits for young African Americans, including fewer intentions to smoke, greater likelihood of quitting, and less relapse.
  
  
  CONCLUSIONS
  Physician communication about smoking may hold particular promise for African-American teens, reducing health disparities because of racial differences in smoking-related mortality and morbidity. Physicians should be encouraged to screen and advise all young people about tobacco, regardless of race or smoking status.
authors.affiliation: Department of Psychiatry, Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University and The Miriam Hospital, Providence, Rhode Island. Electronic address: ashley_clawson@brown.edu.
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Clawson
authors.affiliation: Department of Psychology, The University of Memphis, Memphis, Tennessee.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Robinson
authors.affiliation: Department of Psychology, The University of Memphis, Memphis, Tennessee.
authors.forename: Jeanelle S
authors.initials: JS
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D003142:Communication; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D033182:Intention; D008137:Longitudinal Studies; D008297:Male; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D012907:Smoking / Q000208:ethnology; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires
keywords: Adolescent; Communication; Physicians; Smoking