Tobacco Facts


  • Children who are exposed to parents, older siblings, or peers who smoke are at high risk for initiating use
  • Youth smokers underestimate the disapproval of peers and overestimate peer/adult smoking rates
  • There is a relationship between children’s experiences in managing stress and their intentions to smoke

Healthcare Provider

  • Uniquely positioned to influence children’s perceptions of health risk
  • Can be trained to tailor health messages to their patients’ stage of cognitive development messages about the health risks must be developmentally appropriate
  • Pediatricians must identify children’s psychological vulnerabilities and parental/family difficulties and to assist both parents and children to manage them
  • Message for parents to quit should be integrate with the primary prevention
  • Message to children must initiate early and repeated tobacco use prevention counseling


  • Lack of knowledge and skills in delivering motivational counseling or smoking cessation counseling
  • Limited time
  • Lack of patient education resources
  • Limited use of office staff to assist in delivering counseling interventions

Overcoming the Barriers

  • Offices should use a team approach to address key elements of care delivery: identification, assessment, patient education and counseling, patient follow-up, and monitoring and feedback to staff
  • Refer patients to resources and services already available and set up


  • Tobacco use remains the leading preventable cause of death in the United States causing nearly 440,000 deaths each year and resulting in an annual cost of more than $75 billion in direct medical cost
  • Nationally, smoking results in more than 5.5 million years of potential life lost each year
  • The majority of adult smokers started smoking by the age of 18. Every day, an estimated 3,900 young people under the age of 18 try their first cigarette
  • More than 6.4 million children living today will die prematurely because of a decision they will make as adolescents — the decision to smoke cigarettes


Tobacco Use Prevention in Pediatric Primary Care Settings
Published in: Medicine and Health/Rhode Island, 1998;81(4) 149-150

CDC. Youth Risk Behavior Surveillance—United States, 2005. Morbidity & Mortality Weekly Report 2006;55(SS-5):1–108.