Healthcare providers’ use of brief clinical interventions for adolescent smokers

Abstract

Aims: Numerous studies document the effectiveness of intensive clinical interventions to treat tobacco dependence in adult smokers. Empirical studies have provided limited support for the efficacy of such interventions among adolescent smokers, yet participation, retention, and quit rates associated with these interventions tend to be relatively low. Brief clinical interventions may be a promising alternative for promoting smoking cessation in adolescents. The purpose of this paper is to examine the efficacy and use of brief clinical interventions for adolescent smokers, healthcare providers’ provision of such treatment, barriers to adoption, and policies to increase brief clinical intervention provision.

Methods: Studies were collected from the Centers for Disease Control and Prevention's Office of Smoking and Health, Medline, Psychinfo, PubMed, and the Cochrane Library. We also examined references identified from pertinent articles and books and elicited suggestions from experts in the field of tobacco control. Investigations were primarily confined to those conducted in the USA to allow ease of comparisons among studies. In addition, we chose to concentrate on research conducted in the USA because differences between the USA healthcare system and that of other countries would result in different barriers to adoption and policy recommendations.

Findings: Results showed that, although healthcare professionals appear to be screening adolescents for their smoking status, rates of counseling and follow-up are disappointingly low. Obstacles to brief clinical intervention adoption include clinicians’ lack of knowledge and confidence regarding brief intervention delivery, lack of understanding regarding the unique use patterns of adolescent smokers, and focus on prevention instead of treatment. Clinician training can increase the confidence with which healthcare providers interact with their adolescent patients. Organizational changes include chart reminders, reimbursement for counseling, and staff behavior monitoring.

Conclusions: Additional studies on efficacious methods to help adolescent smokers quit smoking are critically needed. Research on ways in which to increase brief clinical intervention provision are also warranted to prevent teenage smokers from carrying this habit, along with its associated morbidity and mortality risks, into adulthood.

• Healthcare provider
• physician
• smoking
• intervention
• adolescents