Trends in Healthcare Provider Advice on Youth Tobacco Use, 2011-2015

Introduction: The American Academy of Pediatrics issued a policy statement to recommend screening all adolescents for tobacco and other drug use in 2011. This study sought to evaluate the trends of health professional screening and advice on youth tobacco use since then. Methods: Data from the 2011, 2013, and 2015 National Youth Tobacco Survey were analyzed to report the changes in tobacco screening and advice among 46,554 U.S. middle and high school students. Logistic regressions were used to assess trends and factors associated with screening or advice on tobacco use and to examine whether screening or advice on tobacco use was associated with quit behaviors. Analyses were conducted in 2017. Results: Overall, the prevalence of tobacco screening significantly increased from 32.0% in 2011 to 37.9% in 2013 but had no significant change after that. The increase was largest among females and blacks, but there was no significant increase among e-cigarette users. By contrast, the prevalence of being advised not to use tobacco significantly decreased from 31.4% in 2011 to 26.9% in 2015. The decrease was largest among females, younger students, and e-cigarette users. Current cigarette smokers were more likely than nonsmokers to be advised on tobacco use, but no significant difference was found between e-cigarette only users and noncurrent users. Being advised not to use tobacco was associated with higher odds of planning to quit tobacco use among current tobacco users and current e-cigarette users, respectively. Conclusions: Continued efforts to increase tobacco use interventions by healthcare providers are needed. Am J Prev Med 2018;55(2):222-230. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.