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

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.