Counseling youth in tobacco-use prevention: Determinants of clinician compliance

Objective. The rate and determinants of tobacco prevention and cessation counseling to youth were examined for orthodontists participating in a controlled trial to decrease the incidence of tobacco use among adolescents. Methods. A cross-sectional interview design in private practice offices throughout Southern California was used. The survey was completed with 126 (82%) orthodontists. Clinicians randomly assigned to the experimental group (N = 77) received a 1.5 h workshop, anti-tobacco materials, reimbursement for provision of anti-tobacco prescriptions, and quarterly checkup visits. Control group clinicians (N = 77) did not receive training, materials, or visits. Results. Experimental group clinicians talked to more adolescent nonsmokers about never beginning tobacco use than did control group clinicians (P < 0.05). Experimental group clinicians talked to more adolescent tobacco users than did control group clinicians; however, the difference was not statistically significant. Content and determinants of counseling were affected by participation in the intervention. Conclusions. Though training and support increased prevention and cessation counseling, absolute rates remained less than optimal. Social learning factors were associated with prevention and cessation counseling. (C) 1999 American Health Foundation and Academic Press.