A physician's guide to preventing tobacco use during childhood and adolescence

Smoking is a major cause of disease and premature death in the United States. Most smokers begin at an early age, and frequently go on to use alcohol, marijuana, and illicit drugs. The physician can play an extremely important role in helping to educate children and prevent them from taking up smoking. It is recommended that a child visit a physician for health supervision at least 20 times before the age of 21. During this time period, the physician encounters the child at a wide range of levels of intellectual and social development. A physician should adjust smoking education and prevention messages to the level at which the child is developmentally. For children up to age five, the best preventive method is to encourage the parents to stop smoking, not only for their own health, but also for the child's. Discussions about smoking or chewing tobacco should begin at age five. The child should be asked if he or she has tried smoking or if friends smoke, and should then be advised not to smoke. Adolescents should also be asked about smoking, although a questionnaire may be a less threatening way to elicit information. Physicians should personalize advice to give up smoking so that it directly relates to the patient. For those who do smoke, physicians should encourage and help them to seek ways to quit smoking. Again, follow-up visits are important. Physicians can and should play a significant role in preventing young people from taking up smoking. (Consumer Summary produced by Reliance Medical Information, Inc.)