Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a “state-of-the-art” article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco.
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April 2015
State-of-the-Art Review Article|
April 01 2015
State-of-the-Art Office-Based Interventions to Eliminate Youth Tobacco Use: The Past Decade
Lori Pbert, PhD;
aDepartment of Medicine; and
Address correspondence to Lori Pbert, PhD, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655. E-mail: Lori.Pbert@umassmed.edu
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Harold Farber, MD;
Harold Farber, MD
bDepartment of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas;
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Kimberly Horn, EdD;
Kimberly Horn, EdD
cDepartment of Prevention and Community Health, The George Washington University, Washington, District of Columbia;
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Harry A. Lando, PhD;
Harry A. Lando, PhD
dDivision of Epidemiology, University of Minnesota, Minneapolis, Minnesota;
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Myra Muramoto, MD;
Myra Muramoto, MD
eDepartment of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona;
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Jennifer O’Loughlin, PhD;
Jennifer O’Loughlin, PhD
fDepartment of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada;
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Susanne Tanski, MD;
Susanne Tanski, MD
gDepartment of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire;
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Robert J. Wellman, PhD;
Robert J. Wellman, PhD
hDepartment of Family Medicine and Community Health University of Massachusetts Medical School, Worcester, Massachusetts;
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Jonathan P. Winickoff, MD;
Jonathan P. Winickoff, MD
iDepartment of Pediatrics, Harvard Medical School, Boston, Massachusetts; and
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Jonathan D. Klein, MD
on behalf of the American Academy of Pediatrics, Julius B. Richmond Center of Excellence Tobacco Consortium
Jonathan D. Klein, MD
jJulius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois
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Address correspondence to Lori Pbert, PhD, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655. E-mail: Lori.Pbert@umassmed.edu
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2015) 135 (4): 734–747.
Article history
Accepted:
January 13 2015
Citation
Lori Pbert, Harold Farber, Kimberly Horn, Harry A. Lando, Myra Muramoto, Jennifer O’Loughlin, Susanne Tanski, Robert J. Wellman, Jonathan P. Winickoff, Jonathan D. Klein; on behalf of the American Academy of Pediatrics, Julius B. Richmond Center of Excellence Tobacco Consortium, State-of-the-Art Office-Based Interventions to Eliminate Youth Tobacco Use: The Past Decade. Pediatrics April 2015; 135 (4): 734–747. 10.1542/peds.2014-2037
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