Speaker Notes Paper
Smoking is the most prevalent preventive risk factor for cardiovascular disease, cancer, and respiratory ailments. Smoking poses a considerable health risk to the adolescent population due to the stage of development, which is defined by fast growth in physical, social, and cognitive domains.
Adolescents are more prone to experiment with new things, both beneficial and detrimental to their health, due to their innate curiosity, which is a normal phase of cognitive growth in that age group. This is the most common age for smoking initiation, with statistics showing that 9 out of 10 adult smokers began smoking by the age of 18 years (CDC, 202). This is a compelling statistic to capitalize on and plan how to target the teenage demographic to lower the risk of smoking initiation and progression to adulthood.
The United States Preventive Services Task Force (USPSTF) has recommended solutions to the adolescent health epidemic. According to the USPSTF et al. (2020) , smoking should be discouraged from a young age when initiation is high and behavior is readily controlled to lo,wer the proportion of adult smokers. The health promotion plan is detailed in further depth in the next set of slides.
Current statistics depict smoking in the adolescent population as a burden on both the group and the public healthcare system. There is considerable fear that if teenage smoking rates continue steady, 5.6 million persons under the age of 18 will die in the United States from smoking-related diseases, or one in every 13 Americans aged 17 and younger (CDC, 2022).
The adolescent population is a target for many health promotion programs in terms of smoking cessation initiatives, as many people start smoking at this age, with CDC (2022) statistics indicating that nine out of ten adult smokers who smoke daily tried their first cigarette by the age of 18, that approximately 1600 youth smoke their first cigarette every day, and that nearly 200 youth start smoking daily (CDC, 2022).
From 1999 to 2018, data from 143 countries on the prevalence and trends in tobacco use among adolescents aged 13 to 15 were pooled. The global prevalence of cigarette smoking was 11.3% in boys and 6.1% in girls, based on cigarette smoking at least one day in the preceding 30 days (Ma et al., 2021). While the gender gap in cigarette smoking is not uncommon, one contributing factor might be widespread social and cultural disapproval of female smoking.
Tobacco products differ in their proclivity for smoking or consumption. E-cigarettes, for example, are the most often used tobacco products among teens, with 1 in 35 middle school students (2.8%) and 1 in 9 high school students (11.3%) using them in the past 30 days (CDC, 2022).
Furthermore, one in every 100 middle school students (1.0%) and two in every hundred high school students (1.9%) use the smoking variant, one in every 100 middle school students (0.4%) and one in every hundred high school students (1.1%) use hookah, one in every 100 middle school students (0.3%) and one in every hundred high school students (1.1%) use nicotine pouches, the chewed variant (CDC, 2022).
The stark data presenting smoking as a significant burden among the school-aged population give enough urgency to address the public health risk early on by implementing adolescent-targeted health promotion initiatives.
Adolescents experience robust growth and development in physical, cognitive, and social spheres. They grow more interested as part of their cognitive development and changes and are more prone to try new things, including partaking in health-risk activities such as smoking (Khalil et al., 2018).
Furthermore, teenage social and physical environments have an important role in predisposing them to smoke. Adolescent smoking is caused by social and environmental factors, such as the media portraying smoking as a normal habit and parents and friends who smoke.
Furthermore, biological and genetic factors play a role, with Khouja et al. (2021) indicating that adolescents are more sensitive to nicotine and get addicted to it sooner than adults. Other variables that may predispose teenagers to smoke include the belief that smoking alleviates anxiety and despair, a lack of social support from parents, a lack of understanding of how to say no, and a lower socioeconomic position (CDC, 2022). Because the predisposing factors for adolescent smoking are established, adolescents may benefit tremendously from preventive health initiatives centered on each risk factor.
There is sufficient evidence that primary care-accessible behavioral interventions not only serve to reduce smoking initiation among school-aged children and adolescents but also, although with somewhat lower effectiveness, aid with cigarette cessation in this group. The first stage of the implementation process includes identifying and determining cigarette-smoking adolescents. The next slide goes into additional depth about the successful behavioral strategies for supporting teenagers in reducing smoking initiation.
The table above shows the four approaches utilized to accomplish behavioral interventions to reduce tobacco smoking among teenagers. It should be noted that the success of the approaches varies, and this is due in part to the age of the intervention recipient. Print materials are more effective at different ages than computer-based programs; however, all are employed in the school-aged and teenage populations.
A multimodal strategy is usually advocated since no research favors one technique over another. In their recommendation statement, the USPSTF et al. (2020) go on to explain that there is no difference in efficacy dependent on the intervention recipient, clinician, modality, or context, meaning that there is no optimum method over another and that a multimodal approach is necessary.
To lessen the burden of adolescent smoking, healthcare professionals must build a strong alliance with the adolescent population to work toward and achieve mutually agreed-upon goals. The alliance’s three primary goals are to (1) reduce the number of teenagers who are current cigarette smokers, (2) reduce the number of adolescents who smoked cigarettes in the previous 30 days, and (3) raise adolescent awareness of the dangers of smoking, its effects on health, and ways to prevent initiation.
To achieve the three key objectives, interventions must evolve around each of the adolescent smoking predisposing factors. They may include reducing television time, replacing television time with healthy activities such as exercise, and participating in educational programs aimed at reducing the burden among the targeted population.
Having the same goals puts the target audience and healthcare professionals in the same mindset for action and makes them responsible for their efforts. The collaboration instills in the adolescent population the notion that they are vital players in the global economy and that their health is a priority that must be protected at all costs.
The slide above describes the evaluation techniques for the chosen topic’s educational session outcomes. How will educators guarantee that learning occurs? The audience, which will include school-aged and teenage adolescents, will be asked to complete a questionnaire that will assess their knowledge of numerous issues, such as the reasons for smoking, the impacts on health, and health preventive and promotion initiatives. The audience will then be separated into focus groups to think about and debate the issues further.
Questionnaires and reflection questions will tremendously assist in identifying whether or not learning is occurring. The surveys and reflection questions will evaluate a person’s grasp of the topic, areas for development, and areas for improvement if a similar program is done in the future.
The slide above answers the following two questions
- What are the Healthy People 2030 Objectives in alignment with adolescent smoking?
- What are the leading health indicators that are used to track the progress of the health promotion strategies that have been implemented?
Epidemiologic indicators such as numbers and percentages may be used to evaluate the effectiveness of the primary care-feasible behavioral, educational intervention in decreasing adolescent smoking. An example of how percentages have been utilized to indicate the progress of an intervention aimed at reducing water pipe smoking among teenage students is provided
The necessity for reform of the “Healthy People’ objectives has been acknowledged above.
National, state, and local programs may also implement strategies to reduce youth tobacco product use at their respective levels. Some of the interventions are listed above.
The USPSTF concludes and recommends that primary care clinicians provide interventions, including education or brief counseling, to prevent the initiation of tobacco use among school-aged children and adolescents. Because of the surge in teenage tobacco smoking, the interventions must be implemented with the greatest haste. More than one strategy might be used to meet all of the target audience’s diverse learning styles.
Bashirian, S., Barati, M., Sharma, M., Abasi, H., & Karami, M. (2019). Water Pipe smoking reduction in the male adolescent students: An educational intervention using Multi-Theory Model. Journal of Research in Health Sciences, 19(1), e00438. https://www.ncbi.nlm.nih.gov/pubmed/31133627
CDC. (2022, August 22). Youth and tobacco use. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm
Khalil, G. E., Calabro, K. S., & Prokhorov, A. V. (2018). Development and initial testing of the brief adolescent smoking curiosity scale (ASCOS). Addictive Behaviors, 78, 67–73. https://doi.org/10.1016/j.addbeh.2017.11.008
Khouja, J. N., Wootton, R. E., Taylor, A. E., Davey Smith, G., & Munafò, M. R. (2021). Association of genetic liability to smoking initiation with e-cigarette use in young adults: A cohort study. PLoS Medicine, 18(3), e1003555. https://doi.org/10.1371/journal.pmed.1003555
Ma, C., Xi, B., Li, Z., Wu, H., Zhao, M., Liang, Y., & Bovet, P. (2021). Prevalence and trends in tobacco use among adolescents aged 13-15 years in 143 countries, 1999-2018: findings from the Global Youth Tobacco Surveys. The Lancet. Child & Adolescent Health, 5(4), 245–255. https://doi.org/10.1016/S2352-4642(20)30390-4
US Preventive Services Task Force, Owens, D. K., Davidson, K. W., Krist, A. H., Barry, M. J., Cabana, M., Caughey, A. B., Curry, S. J., Donahue, K., Doubeni, C. A., Epling, J. W., Jr, Kubik, M., Ogedegbe, G., Pbert, L., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2020). Primary care interventions for prevention and cessation of tobacco use in children and adolescents: US preventive services task force recommendation statement: US preventive services task force recommendation statement. JAMA: The Journal of the American Medical Association, 323(16), 1590–1598. https://doi.org/10.1001/jama.2020.4679