Missed opportunities for prevention: failure to identify smoking in the parents of adolescent patients.

Smoking is an addiction that often begins in childhood or adolescence. Factors associated with early smoking initiation include parental smoking and socialization about smoking with their children. Previous studies evaluating the history obtained during routine pediatric appointments have not focused on parental smoking history and counseling. In this study, seventy-three (73) adolescents (mean age: 15.2 years; 77% female; 64% African-American) seen for medical care in a primary care clinic and their accompanying parent(s) (mean age: 43.5 years; 91% female) were surveyed about smoking followed by a review of each chart measuring documentation of adolescent and parent smoking history and counseling. Although the majority of adolescents were questioned about smoking (92%), parents were rarely questioned (1%) (p < 0.05). Adolescents were counseled about smoking (7%) and other risk-taking behaviors (44%); however, no parents were counseled about smoking or smoking socialization. Physicians frequently overlook an important factor in the prevention of smoking initiation at a young age, parental smoking history and counseling.