North Carolina health professionals' communication with adolescents about smoking.

Background: The middle school and high school years are a time when adolescents are at high risk for initiation of smoking and progression to nicotine addiction. This research examines the prevalence with which North Carolina students receive smoking-related communication from health professionals and how such communication relates to smoking behaviors.

Methods: Data are from the 2009 North Carolina Youth Tobacco Survey (NCYTS), a biennial public and charter school-based survey of students in grades 6-12. The overall response rate was 78.2% (n = 3,301) for high school students and 79.2% (n = 3,805) for middle school students. Weighted multivariable logistic regression models were used to identify variables that are significantly related to health professionals' communication about smoking and/or advice against smoking.

Results: A majority of respondents reported that they had not been asked about or advised against smoking. Middle school and high school students who had tried to quit smoking in the past 12 months were significantly more likely to report having been asked about smoking (OR = 2.00 [95% CI, 1.23-3.28], OR = 1.96 [95% CI,1.44-2.661, respectively) or advised against smoking (OR = 2.25 [95% CI,1.13-4.50], OR = 2.02 [95% CI, 1.31-3.14], respectively) than were students who had not tried to quit.

Limitations: This research is based on a cross-sectional survey and is subject to the honesty of the participants. Results may not generalize beyond public and charter school students in North Carolina.

Conclusions: North Carolina health professionals need to increase communication with adolescents in order to sustain the historically low rates of smoking in this age group.