PREVENTION OF TOBACCO USE DURING CHILDHOOD AND ADOLESCENCE - 5 STEPS TO PREVENT THE ONSET OF SMOKING

Background. Most tobacco users become addicted during childhood and ad olescence. To reduce the prevalence of tobacco-related illnesses, more emphasis must be placed on preventing the onset of tobacco use. Physi cians can play a major role. Methods. Based on a series of clinical tr ials, the National Cancer Institute (NCI) developed recommendations to help patients stop smoking. Behavioral and developmental research hav e identified factors that contribute to the onset of smoking. The Amer ican Academy of Pediatrics (AAP) has developed guidelines for health s upervision from birth to adulthood, including engaging parents and chi ldren as partners in health care. The NCI recommendations, behavioral research results, and AAP guidelines were integrated to develop a stra tegy to prevent the onset of tobacco use. Results. The NCI proposes fi ve steps to prevent tobacco use during childhood and adolescence. Ther e are five physician activities, beginning with the letter A, includin g anticipatory guidance, ask, advise, assist, and arrange follow-up. A nticipatory guidance, the practice of counseling for potential problem s, is a key part of health care for the young. The nature of these ste ps varies, depending on the child's age, developmental stage, and beha vior, as well as smoking habits of family members. Conclusion. Despite the long-term consequences of smoking, onset and addiction to tobacco use usually begins in childhood. Therefore, physicians who care for c hildren have a major role in eliminating tobacco use by preventing its onset.