ROLE OF CLINICIAN IN CIGARETTE-SMOKING PREVENTION

Despite a gradual decrease in smoking rates among adults, the proporti on of youth who smoke regularly has remained stable. Among high school students in 1997, 19.9% of white, 7.2% of African American, and 10.9% of Latino youth reported smoking during at least 20 of the previous 3 0 days. Ethnic differences in beliefs, attitudes, and behavior about s moking have not been systematically considered in developing preventio n interventions for adolescents. Effective school-based smoking-preven tion interventions have been developed, but these are usually not appr opriately implemented. Policy proposals and current laws that affect t he marketing of tobacco to youth need to be emphasized as evidence inc reases that marketing by the tobacco industry targets youth and leads to more smoking. Smoking-prevention programs have been designed to inv olve physicians and other health care professionals in the clinical se tting, but limited data exist on their efficacy. We review the guideli nes for involving the clinicians who provide care to children in preve nting the onset of tobacco use, counseling parents of children who smo ke, and counseling adolescents who have started smoking. Finally, we s ummarize the future directions of smoking-prevention research and prog rams.