USPSTF updates tobacco use interventions

The US Preventive Services Task Force (USPSTF) has updated its recommendations for curbing tobacco use among school-aged children and adolescents. Unlike the 2003 recommendation, which concluded that the evidence was insufficient for routine tobacco use screening and intervention, the update includes a number of ways for pediatricians to help prevent tobacco use by their patients.

While overall tobacco usage rates have declined from 2000 to 2011, the US Surgeon General declared adolescent smoking an “epidemic.” According to a 2009 survey, 23.9% of high school students and 8.2% of middle school students indicated current tobacco use.

Interventions aimed at preventing the initiation of tobacco use range from simply making practices completely tobacco-free and giving patients antismoking messages on “prescription” forms to having families participate in group sessions and work on workbook activities at home. Another effective and simple intervention is regularly mailing materials to patients’ homes. For children and adolescents who have started using tobacco products, school- and community-based behavioral counseling programs remain the best way to promote smoking cessation.

In addition to practice-based approaches, the USPSTF recommends using cell phones to create phone-based interventions for tobacco use, campaigning for tobacco price increases as an effective tool for cessation among young persons, and mass-media campaigns and community mobilization that include active enforcement of retail sales laws to reduce kids’ access to tobacco products from commercial sources.

Parental smoking and parental nicotine dependence are the 2 strongest factors that influence whether children begin smoking, and 90% of US adults who have ever smoked on a daily basis report they began smoking when they were aged younger than 18 years. The USPSTF recommends that clinicians ask all adults, especially pregnant women, about their tobacco use and provide tobacco cessation interventions to help them quit.

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