Low Rates of Physicians Counseling Adolescents About Smoking: a Critical Wake-Up Call

Abstract

The report by Thorndike et al. (1) in this issue of the Journal is an important wake-up call to physicians, academic teachers, and researchers. The overall results from this study are discouraging, especially given efforts in recent years to educate practicing physicians to identify and to treat smokers, to develop evidence-based guidelines for smoking cessation treatment (2), and to encourage the development of systems to identify smokers. Although smoking status was identified at approximately 70% of adolescent patient visits, counseling was provided at only 1.7% of all visits and 16.9% of visits of patients identified as smokers. Furthermore, and equally discouraging, there was no improvement in these percentages between 1991 through 1996 despite an article written in 1991 providing a guide for physicians on preventing tobacco use during childhood and adolescence (3). Also of concern was the finding that smoking is less likely to be addressed with minority patients.