November 12, 1999

Few physicians counsel adolescents about smoking

Despite the fact that most smokers take up the habit as adolescents, few U.S. physicians counsel their young patients about the health risks of smoking, according to an MGH study in the Nov. 3 issue of the Journal of the National Cancer Institute. The report found that, even when they knew their patients were smokers, physicians reported discussing smoking at office visits less than 20 percent of the time.

"We were surprised that counseling of all adolescents was so low and that it did not improve during the 1990s, despite the fact that numerous physician and government organizations recommend that all adolescents receive counseling, whether they currently smoked or not," says Anne Thorndike, MD, of the MGH General Medicine Division, the study's lead author.

During the years 1991 through 1996, physicians responding to a national survey reported asking young patients ages 11 to 21 about their smoking habits at 71 percent of office visits. But they provided counseling and advice about smoking at less than 2 percent of overall office visits. In the 8.5 percent of office visits when patients identified themselves as smokers, physicians counseled patients about the risks of smoking and benefits of quitting 17 percent of the time.

"We know that the peak years for young people to begin smoking are ages 13 and 14," Thorndike explains. "Even when youngsters tell their doctors they don't smoke, they may be experimenting with cigarettes or other tobacco products. It's important to get these prevention messages across before they become regular smokers."

Co-authors of the study were Timothy Ferris, MD, of the General Medicine and General Pediatrics divisions, Randall Stafford, MD, General Medicine and the Institute for Health Policy, and Nancy Rigotti, MD, General Medicine and director of Tobacco Research and Treatment.