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Journal of Pediatric Psychology Advance Access originally published online on December 27, 2007
Journal of Pediatric Psychology 2008 33(2):119-132; doi:10.1093/jpepsy/jsm132
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Prevention of Tobacco Use Among Medically At-risk Children and Adolescents: Clinical and Research Opportunities in the Interest of Public Health*

Kenneth P. Tercyak, PhD1, Maria T. Britto, MD, MPH2, Kathleen M. Hanna, PhD, RN3, Patricia J. Hollen, PhD, RN, FAAN4 and Melissa M. Hudson, MD5

1Lombardi Comprehensive Cancer Center and the Departments of Oncology and Pediatrics, Georgetown University Medical Center, 2Center for Innovation in Chronic Care, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, 3School of Nursing, Indiana University, 4School of Nursing, University of Virginia, and 5St Jude Children's Research Hospital

All correspondence concerning this article should be addressed to Kenneth P. Tercyak, PhD, Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007-2401, USA. E-mail: tercyakk{at}georgetown.edu.


  Abstract

Objective Cigarette smoking and other forms of tobacco use are addictive and harmful. Though no level of smoking is safe, children and adolescents who are medically at-risk due to the presence of a chronic or life-threatening disease may be especially vulnerable to these dangers. This article provides an overview of considerations in the prevention of tobacco use in this special population. Methods This article summarizes medical aspects of childhood chronic disease and the impact of cigarette smoking, the prevalence of tobacco screening in pediatric healthcare, and levels of prevention for individuals, families, schools, and healthcare. Recommendations for clinical services and research are also included. Results There are a number of reasons to prevent and interrupt the onset of smoking in medically at-risk youth. Subspecialty clinics appear to be the most likely point of entry for prevention-based work in this area. However, no one single setting will be effective in preventing and deterring use without due consideration of other settings, perspectives, and influences on smoking uptake. Conclusions The promise of smoking prevention to improve the health and outlook of children and adolescents with chronic or life-threatening disease is high, and additional efforts are needed for this population.

Key words: children; chronic disease; chronic illness; prevention; risk behavior; smoking; substance use; tobacco control.

*This article is based on the Proceedings from the Conference "Tobacco Control Strategies for Medically At-Risk Youth" held at St Jude Children's Research Hospital in Memphis, TN on October 6–8, 2005.

Received December 14, 2006; revision received October 5, 2007; accepted October 17, 2007


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