Warehouse Point

Not all doctors offer the same counseling to teens. Here’s study report to help you decide.

Concerned and interested parents of adolescents sometimes rely on medical practitioners and look to them for teen counseling related to smoking prevention and quitting. Not all medical practitioners offer the same screening, counseling, or spend the same amount of time with patients. These parents may be interested in weighing the report of the following survey study conducted at the University of Rochester. They conducted a study on smoking prevention and cessation screening and counseling given to adolescents by various medical practitioners.

What was studied: The researchers set out to describe what screening and counseling was given to adolescents about smoking prevention and quitting and to examine the effect of different factors relating to the physician that would affect this. 371 pediatricians and family doctors in the New York City area responded to the survey, out of 564 invited to participate. In analyzing the results of this study, the doctors’ specialty, gender, familiarity with National Cancer Institute guidelines, time spent with the teen, and the factor of confidentiality –time spent lone with the teen– were measured. The results were associated with better smoking counseling performance.

Questions asked of teens             How may Drs Asked
Asked teens about smoking                                       91%

Assessed smokers on motivation to quit             81%

Helped teens set a quit date                                       34%

Scheduled follow-up visits                                          28%

Asked whether teen’s friends smoked                     41%

Asked about smokeless tobacco use                        32%

In order to measure how good their counseling might be, the study determined whether the doctors were familiar or not with the Guidelines of the National Cancer Institute. The highter that number, the more were the doctors who knew what the Guidelines were and thus would be more likely to provide effective counseling.

Physician Performance and Knowledge                               Family Doctors               Pediatricians

Smoking mean counseling performance score P<.001                    61%                             53%

Familiarity with National Cancer Institute guidelines P<.001            48%                             27%

Next they examined how much time the doctors spent with the teen and whether the discussion took place in private:

Time and Privacy Factors    Female Physicians

time spent with their last adolescent patient 63%

time alone with adolescent patients 85%

From this table, it’s clear that more women doctors spoke in private to the teens than did their male counterparts, though the results didn’t say how the male doctors fared.

To contrast with this, in Nova Scotia, Canada, a trial is ending that couples nurse practitioners with physicians. These nurse practitioners, among other duties, are taking over those tasks that can help the physician better with his or her practice. Among the recognized weaknesses of physicians is counseling. The initial results suggest that the nurse practitioners are making a positive difference, though some physicians continue to resist nurse practitioners because of protection of their traditional territory and autonomy. But dollars, common sense, and demand from consumers for better care may bring about a change for the betterment of the health of citizens. As more nurse practitioners become involved, will they help to make a difference in the area of smoking cessation and prevention? One can only hope.

Tags: smoking, survey, teens