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Journal of Pediatric Psychology Advance Access originally published online on February 23, 2005
Journal of Pediatric Psychology 2005 30(4):371-376; doi:10.1093/jpepsy/jsi031
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Journal of Pediatric Psychology vol. 30 no. 4 © Society of Pediatric Psychology 2005; all rights reserved.

Physician Tobacco Advice to Preteens in a Smoking-Prevention Randomized Trial: Steering Clear

Tim McAfee, MD1, Evette Ludman, PhD2, Lou Grothaus, MA2, Susan M. Zbikowski, PhD1, Terry Bush, PhD3, Jack Hollis, PhD4, Michael Polen, MA4 and Susan J. Curry, PhD5

1 Free & Clear, Tukwila, Washington, 2 Center for Health Studies, Group Health Cooperative, Seattle, Washington, 3 Center for Health Studies, Group Health Cooperative, and Free & Clear, Seattle, Washington, 4 Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, and 5 Health Research and Policy Centers, University of Illinois at Chicago

All correspondence should be sent to Tim McAfee, Free & Clear, 12401 East Marginal Way South, Tukwila, Washington 98168. E-mail: mcafee.t{at}ghchp.com.

Received November 17, 2003; revisions received June 30, 2004; accepted July 6, 2004

Objective To examine preadolescent and parental recall of tobacco prevention messages by health care providers. Methods As part of a smoking prevention trial, providers were cued to reinforce the study and advise intervention participants (N = 4,026) not to use tobacco. All parents were surveyed at baseline; children were surveyed at 20 months; and a subsample (504 households) was surveyed at 6 and 12 months to assess discussion of tobacco use prevention and other health behavior topics by providers as well as susceptibility and experimentation with tobacco among children. Results During the 20-month follow-up, less than 25% of children recalled a provider discussing tobacco use prevention. Recall of exposure to tobacco prevention messages at school (68%), from parents (53%), and from mass media (71%) was higher. Conclusions Physician tobacco counseling is occurring at lower rates in pre-adolescents than it is in adults. A chart reminder to providers was insufficient to create a meaningful effect.

Key words: physician advice; preteens; preadolescents; smoking prevention.


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