Structured Abstract

Contents

• 1. INTRODUCTION
  • Scope and Purpose
  • Burden of Tobacco Use
  • Prevalence and Natural History of Tobacco Use
  • Measurement of Tobacco Use in Children and Adolescents
  • Risk Factors
  • Rationale for Tobacco Use Interventions in Primary Care
  • Prevention and Cessation Interventions
  • Current Clinical Practice
  • Recommendations of Other Groups
  • Previous USPSTF Recommendation
• 2. METHODS
  • Key Questions and Analytic Framework
  • Data Sources and Searches
  • Study Selection
  • Quality Assessment and Data Extraction
  • Data Synthesis and Analysis
  • USPSTF Involvement
• 3. RESULTS
  • Key Question 1 Do Interventions in Primary Care Designed to Prevent Tobacco Use or Improve Tobacco Cessation Rates in Children and Adolescents Improve Health Outcomes in Children and Adolescents and Reduce the Likelihood of Adult Smoking?
  • Key Question 2 Do Interventions in Primary Care Prevent Tobacco Use in Children and Adolescents or Improve Tobacco Cessation Rates in Children and Adolescents Who Use Tobacco? What Are Elements of Efficacious Interventions? Are There Differences in Outcomes in Different Subgroups?
  • Key Question 3 What Adverse Effects Are Associated With Interventions to Improve Tobacco Cessation Rates or Prevent Tobacco Use in Children and Adolescents?
• 4. DISCUSSION
  • Effects of Tobacco Use Interventions
  • Effectiveness of Specific Prevention and Cessation Intervention Strategies
  • Harms of Prevention and Cessation Interventions
  • Assessment of Youth Tobacco Use
  • Applicability
  • Limitations in the Body of Evidence
  • Limitations in Our Approach
  • Future Research
  • Conclusions
• References
• Appendix A Original Search Strategies
• Appendix B Search Results and Progression of Article Inclusion
• Appendix C Excluded Studies
• Appendix D Inclusion/Exclusion Criteria
• Appendix E Comparison of Included Studies
• Appendix F U.S. Preventive Services Task Force Quality Criteria and Ratings
• Appendix G Behavioral Intervention Details
• Appendix H Trials Pending Assessment

Expert consultant: Jack Hollis, PhD

Acknowledgments: The authors acknowledge the following individuals for their contributions to this project: Therese Miller, DrPH, at the Agency for Healthcare Quality and Research; Susan J. Curry, PhD, David Grossman, MD, MPH, and J. Sanford Schwartz, MD, of the U.S. Preventive Services Task Force; Raymond S. Niaura, PhD, Steven Sussman, PhD, MA, Andrea C. Villanti, PhD, MPH, and Jonathan Winickoff, MD, MPH, who provided expert review of the report; and Kevin Lutz, MFA, Daphne Plaut, MLS, and Heather Baird at the Center for Health Research.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. HHS-290-2007-10057-I, Task Order No. 13. Prepared by: Oregon Evidence-based Practice Center, Center for Health Research, Kaiser Permanente Northwest²

Suggested citation:

Patnode CD, O'Connor E, Whitlock EP, Perdue LA, Soh C. Primary Care Relevant Interventions for Tobacco Use Prevention and Cessation in Children and Adolescents: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 97. AHRQ Publication No. 12-05175-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; December 2012.

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHS-290-2007-10057-I, Task Order No. 13). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information; that is, in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

1

540 Gaither Road, Rockville, MD 20850; www​.ahrq.gov

2

3800 North Interstate Avenue, Portland, OR 97227