Smoking cessation counseling in adults and children: the clinician's role.

Clinicians can profoundly improve the nation's health by implementing recently developed smoking cessation counseling strategies. Although not specifically validated for children and adolescents, young people are likely to benefit from many of the methods used successfully with adults. In the "minimal contact" setting of an office visit, clinicians can achieve substantial long-term quit rates by identifying all smokers through the medical chart, enlisting the help of ancillary personnel, focusing on patients who are ready to quit, and arranging follow-up. Physicians are more likely to be effective if they recognize that smoking cessation is a long-term process that may require multiple quit attempts for success. This article reviews office-based approaches to smoking cessation counseling, tobacco use prevention in children and adolescents, and pharmacologic treatment of nicotine addiction.