Half of Teen Nicotine Users Don't Receive Health Provider Warnings, National Study Reveals

Co-authors from The University of Texas School of Public Health San Antonio conducted research showing concerning gaps in preventive counseling, with at-risk groups least likely to get advice

Despite nicotine use being a leading preventable cause of cancer, only about half of American teenagers receive advice from healthcare providers about avoiding tobacco and nicotine products, according to research presented at the American Society of Clinical Oncology Annual Meeting on May 31. Michael T. Halpern, MD, PhD, MPH, Chair of the Department of Health Policy and Health Services Administration and Tracey E. Barnett, PhD, Chair of the Department of Quantitative and Qualitative Health Sciences were co-authors for the study.

The study, presented in a poster by Halpern, examined responses from over 16,000 middle and high school students. The research found that just 51.3% of current nicotine users and 44% of non-users received guidance from doctors, dentists, or nurses about avoiding cigarettes, e-cigarettes, and other nicotine products during healthcare visits in the past year.

The researchers emphasized that most nicotine addiction begins during the teenage years, making provider intervention during this period particularly crucial.

The research, based on data from the 2021 National Youth Tobacco Survey, uncovered troubling disparities in who receives preventive counseling. Older students, who face higher risks of nicotine use, were actually less likely to receive advice from healthcare providers. Female students, another group with elevated risk factors, also received less counseling than their male peers.

Among current users, the disparities were particularly stark. For each year of age, teens were 15% less likely to receive anti-nicotine advice, while male users were 2.5 times more likely than female users to receive such guidance.

The study also revealed socioeconomic and racial disparities in preventive counseling. Among non-users, students from highly affluent families were 20% more likely to receive advice compared to less affluent peers. Non-Hispanic Black students were more likely to receive counseling than non-Hispanic White students, though White students showed higher rates of actual nicotine use.

With nearly 8% of surveyed students reporting current use of nicotine products - including traditional cigarettes, e-cigarettes, and other tobacco products - the UT School of Public Health San Antonio researchers emphasized the urgent need for healthcare providers to consistently address nicotine use with all adolescent patients.

The findings, presented at one of oncology's premier scientific meetings, come as public health officials continue to grapple with rising e-cigarette use among teenagers and persistent disparities in tobacco-related health outcomes across different demographic groups.