The role of the pediatrician in smoking prevention.

Smoking prevention during childhood and adolescence is critical to the successful reduction of tobacco-related morbidity and mortality in the United States. The research literature is replete with surveys describing youth smoking acquisition and related factors. In addition to its direct harm, tobacco use may be a gateway to other substance abuse and a marker of other health-compromising behaviors. The pediatrician can play an important role in prevention by screening all patients and providing individual counseling. The pediatrician can also contribute as a consultant and advocate of school- and community-based smoking prevention efforts. Such a multicomponent approach provides the greatest likelihood of accelerating the decline in smoking and smokeless tobacco initiation.