Healthcare Provider Screening and Counseling for Youth Tobacco Use in the U.S.: Findings From the 2022 National Youth Tobacco Survey.

Abstract

Healthcare providers can address youth tobacco use through screening and counseling; however, provision remains inconsistent. Data from the 2022 National Youth Tobacco Survey, a cross-sectional survey of U.S. middle- and high-school students, were analyzed to assess the prevalence and factors associated with healthcare provider screening and counseling for youth tobacco use using descriptive statistics and logistic regression. Among 24,644 youth, 43.7% were screened, and 45.6% were counseled for any tobacco use. Males had higher odds of being counseled than females (AOR=1.37, 95% CI=1.25, 1.49, p<0.001). Youth aged 13-15 years and 16-18 years had higher odds of being screened (AOR=2.44, 95% CI=2.10, 2.83 and AOR=4.96, 95% CI=4.03, 6.06, p<0.001), and those aged 16-18 years had higher odds of being counseled than those aged 9-12 years (AOR=1.32, 95% CI=1.09, 1.61, p=0.005). Non-Hispanic Black (screened: AOR=0.71, 95% CI=0.60, 0.84, p<0.001; counseled: AOR=0.84, 95% CI=0.71, 0.99, p=0.037), Hispanic (screened: AOR=0.77, 95% CI=0.67, 0.89, p<0.001; counseled: AOR=0.83, 95% CI=0.72, 0.95, p=0.008), and non-Hispanic Asian (screened: AOR=0.65, 95% CI=0.48, 0.87, p=0.004; counseled: AOR=0.63, 95% CI=0.53, 0.74, p<0.001) youth had lower odds of both outcomes than non-Hispanic White youth. Youth with current sole (screened: AOR=1.51, 95% CI=1.24, 1.85; counseled: AOR=1.38, 95% CI=1.16, 1.64, p<0.001) or dual/poly (screened: AOR=1.69, 95% CI=1.27, 2.24, p<0.001; counseled: AOR=1.52, 95% CI=1.13, 2.05, p=0.006) tobacco use had higher odds of being screened and counseled than those reporting noncurrent use. Fewer than half of U.S. youth reported receiving tobacco screening or counseling, with disparities across sociodemographic and tobacco use groups. Ongoing training for healthcare providers and enhancements to electronic health records may improve equitable access to tobacco prevention and cessation services for youth.