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PCPs should screen, intervene with young smokers regardless of smoking intensity

BALTIMORE — Clinicians and primary care physicians should screen and work with young smokers regardless of how often and how much they smoke, and should also be aware that teens who are light or intermittent smokers may not report this behavior, according to data presented at the Pediatric Academic Societies Meeting.

“Youth who smoke lightly or intermittently are at high risk for continuing to smoke, and even light smoking presents significant health risks, such as cardiovascular disease and lung cancer,” Julie Gorzkowski, MSW, LSW, senior research associate with the Julius B. Richmond Center of Excellence at the American Academy of Pediatrics (AAP), said during her presentation. “Despite those risks, light and intermittent smokers may believe their tobacco use is less dangerous than that of heavier smokers. Intermittent and light smokers do not always identify as smokers or report smoking behavior, which can complicate a clinician’s ability to screen for tobacco use in practice.”

Julie Gorzkowski, MSW, LSW

To determine the patterns of light and intermittent smoking, and its relationship to the smoker’s intention to quit, Gorzkowski and colleagues studied self-reported behaviors and attitudes among a cohort of youth during the Adolescent Health in Pediatric Practice study, from the AAP Pediatric Research in Office Settings network. The study included 602 teenage smokers, with a mean age of 17.25, from 115 practices in 39 states, who completed surveys at baseline, 4 to 6 weeks, 6 months and 1 year. The researchers used chi-square analyses and t-tests to assess demographics, smoking behaviors and intentions.

According to the researchers, 57% of those who completed the follow-up surveys were intermittent, or nondaily, smokers at baseline. Of the 414 who reported their daily habits, 67% reported smoking five or less per day. Intermittent and light smokers were more likely to be younger than 18 (P = .004; P = .016), and above-average students (P < .001; P = .011) than their heavy-smoking peers, defined as those who smoke six or more cigarettes per day. In addition, intermittent and light smokers were less likely to identify as smokers (P < .001), and more to report they received a less-intensive tobacco intervention during clinical visits than heavy-smoking teens (P = .001).

Among intermittent smokers, 73% reported a desire to quit at 4 to 6 weeks, compared with 83% of heavy smokers (P = .026), and only 47% of intermittent smokers reported a quit attempt compared to 64% of heavy smokers (P < .001). Similarly, among light smokers, 71% reported wanting to quit at 6 months, compared with 83% of daily smokers (P = .029), and were less likely than daily smokers to report a recent attempt at 4 to 6 weeks (52% vs 73%, P < .001), 6 months (44% vs. 58%, P = .03) and 1 year (35% vs 60%, P = .023).

“Light and intermittent smoking patterns present unique challenges for clinical screening and intervention, because these youths may not always identify as smokers and may be less motivated to quit,” Gorzkowski said. “Clinicians should screen and intervene with all smokers regardless of the intensity of their smoking habit, because there is no safe level of tobacco use.” – by Jason Laday

Disclosure: Gorzkowski reports no relevant financial disclosures.

Reference:

Gorzkowski J, et al. Intermittent and light smoking patterns among youth. Presented at: Pediatric Academic Societies meeting; April 30 to May 3, 2016; Baltimore.