Health News

Identifying Teen Smokers

March 5, 2000 (San Diego) -- Asking the right questions, including a simple one like "Does your mother or father smoke?," can effectively sort the teen smokers from the nonsmokers, says a pediatrician who tests the results of his smoking questionnaire with a urine test for a tobacco by-product.

Doctors have long been expected to offer counseling about quitting but didn't know how to identify the teens who needed help. Samuel S. Gidding, MD, tested a questionnaire that he developed on 124 teens treated at a suburban Chicago pediatric practice. He presented his study at an American Heart Association meeting here. Gidding is associate professor of pediatrics and preventive medicine at Northwestern University Medical School in Chicago.

He says he used the urine test for the tobacco by-product called cotinine to "confirm the results of the questionnaire." The teens were assured of "absolute confidentiality concerning their answers on the questionnaire, and generally they were very honest."

Only three teens, one regular smoker and two experimenters, said they were nonsmokers yet had positive cotinine tests, he says. Gidding says laboratory tests for cotinine have been available for some time. "You can use either urine or saliva for testing, and the tests cost about $20-40," he says.

Although the questionnaire had 24 questions, "there are really four essential areas that are key to identifying smokers," says Gidding. Those areas are smoking by family members, smoking by friends, grade in school, and "smoking in the past month."

Seventy-three percent of smokers and 44% of experimenters have a family member who smokes, Gidding says. "Among both smokers and experimenters, they said that more than half of their friends smoked," he says. The age at which teens are likely to first experiment with cigarettes is 13, and with each additional year the likelihood that a teen will smoke increases. "So grade in school is key because there are more 12th graders than 9th graders who smoke," says Gidding. Asking about frequency is important, he says, because smoking "just one cigarette a month is a clear indication of an experimenter, and this is the group that needs to be targeted for an intervention."

Gidding says teens who are regular smokers are as addicted to nicotine as adult smokers, so efforts to quit can be just as difficult as for adults. "Unfortunately, we don't have good programs for smoking cessation aimed at teens," says Gidding. But among experimenters, the simple intervention of a doctor telling them "that they should stop smoking is actually very effective."

J. Timothy Bricker, MD, professor of pediatrics at Baylor College of Medicine in Houston, tells WebMD that the take-home message from Gidding's study is that "it is good practice in adolescent medicine to ask questions about smoking and to be prepared to do an intervention." Bricker is also chief of cardiology at Texas Children's Hospital in Houston.