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. 1991 Oct 19;303(6808):947–950. doi: 10.1136/bmj.303.6808.947

Adolescent smokers seen in general practice: health, lifestyle, physical measurements, and response to antismoking advice.

J Townsend 1, H Wilkes 1, A Haines 1, M Jarvis 1
PMCID: PMC1671366  PMID: 1755876

Abstract

OBJECTIVE--To compare physical, lifestyle, and health characteristics of adolescent smokers and non-smokers and their initial response to anti-smoking counselling. DESIGN--Adolescents aged 13, 15, and 17 years were identified from age-sex registers and invited by letter for a general practice health check. SETTING--Three general practices in the MRC general practice research framework. MAIN OUTCOME MEASURES--Blood pressure, body mass index, saliva cotinine concentration, peak flow rate, alcohol consumption, exercise, duration of sleep, and stated persistent health problems. RESULTS--73% of the adolescents (491) attended for the health check. A total of 68 (14%) were regular smokers. By age 17 those who smoked regularly had a significantly lower systolic blood pressure than those who had never smoked regularly (by 6 mm Hg; p = 0.025) despite a significantly higher body mass index (by 1.5; p <0.001) [corrected]. Cotinine concentrations increased with smoking exposure, from 0.7 ng/ml when no family member smoked to 155 ng/ml in active smokers of six or more cigarettes a week. Significantly more regular smokers than never regular smokers drank greater than or equal to 8 g alcohol a day (chi 2 = 15.2 adjusted for age and sex p less than 0.001); regular smokers exercised less (1.0 hrs/week in boys and 0.8 hrs/week in girls v 3.4 hrs/week in boys and 2.2 hrs/week in girls; p less than 0.001) and slept less (8.0 hrs/night v 8.5 hrs/night at age 17; p less than 0.005). Persistent health problems, mostly asthma or allergic symptoms, were reported by 25% (17/68) of the smokers and 16% (60/381) of the non-smokers. Of the smokers given counselling, 60% (26/43) made an agreement with the practice doctor or nurse to give up smoking. CONCLUSION--General practice is an appropriate setting for adolescents to receive advice on healthy lifestyle, which should not focus solely on smoking.

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Selected References

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  1. Catford J. C., Nutbeam D., Woolaway M. C. Effectiveness and cost-benefits of smoking education. Community Med. 1984 Nov;6(4):264–272. [PubMed] [Google Scholar]
  2. Croft P., Hannaford P. C. Risk factors for acute myocardial infarction in women: evidence from the Royal College of General Practitioners' oral contraception study. BMJ. 1989 Jan 21;298(6667):165–168. doi: 10.1136/bmj.298.6667.165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cutler S. F., Wallace P. G., Haines A. P. Assessing alcohol consumption in general practice patients--a comparison between questionnaire and interview (findings of the Medical Research Council's general practice research framework study on lifestyle and health). Alcohol Alcohol. 1988;23(6):441–450. [PubMed] [Google Scholar]
  4. Green M. S., Jucha E., Luz Y. Blood pressure in smokers and nonsmokers: epidemiologic findings. Am Heart J. 1986 May;111(5):932–940. doi: 10.1016/0002-8703(86)90645-9. [DOI] [PubMed] [Google Scholar]
  5. Jamrozik K., Vessey M., Fowler G., Wald N., Parker G., Van Vunakis H. Controlled trial of three different antismoking interventions in general practice. Br Med J (Clin Res Ed) 1984 May 19;288(6429):1499–1503. doi: 10.1136/bmj.288.6429.1499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Janerich D. T., Thompson W. D., Varela L. R., Greenwald P., Chorost S., Tucci C., Zaman M. B., Melamed M. R., Kiely M., McKneally M. F. Lung cancer and exposure to tobacco smoke in the household. N Engl J Med. 1990 Sep 6;323(10):632–636. doi: 10.1056/NEJM199009063231003. [DOI] [PubMed] [Google Scholar]
  7. Jarvis M. J., Russell M. A., Feyerabend C., Eiser J. R., Morgan M., Gammage P., Gray E. M. Passive exposure to tobacco smoke: saliva cotinine concentrations in a representative population sample of non-smoking schoolchildren. Br Med J (Clin Res Ed) 1985 Oct 5;291(6500):927–929. doi: 10.1136/bmj.291.6500.927. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kershaw C. R. Passive smoking, potential atopy and asthma in the first five years. J R Soc Med. 1987 Nov;80(11):683–688. doi: 10.1177/014107688708001108. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Macfarlane A., McPherson A., McPherson K., Ahmed L. Teenagers and their health. Arch Dis Child. 1987 Nov;62(11):1125–1129. doi: 10.1136/adc.62.11.1125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. McNeill A. D., Jarvis M. J., West R., Russell M. A., Bryant A. Saliva cotinine as an indicator of cigarette smoking in adolescents. Br J Addict. 1987 Dec;82(12):1355–1360. doi: 10.1111/j.1360-0443.1987.tb00439.x. [DOI] [PubMed] [Google Scholar]
  11. Murray M., Swan A. V., Clarke G. Long term effect of a school based antismoking programme. J Epidemiol Community Health. 1984 Sep;38(3):247–252. doi: 10.1136/jech.38.3.247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Richmond R., Webster I. Evaluation of general practitioners' use of a smoking intervention programme. Int J Epidemiol. 1985 Sep;14(3):396–401. doi: 10.1093/ije/14.3.396. [DOI] [PubMed] [Google Scholar]
  13. Russell M. A., Wilson C., Taylor C., Baker C. D. Effect of general practitioners' advice against smoking. Br Med J. 1979 Jul 28;2(6184):231–235. doi: 10.1136/bmj.2.6184.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. St George I. M., Williams S., Stanton W. R., Silva P. A. Smoking and blood pressure in 15 year olds in Dunedin, New Zealand. BMJ. 1991 Jan 12;302(6768):89–90. doi: 10.1136/bmj.302.6768.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wallace P. G., Brennan P. J., Haines A. P. Are general practitioners doing enough to promote healthy lifestyle? Findings of the Medical Research Council's general practice research framework study on lifestyle and health. Br Med J (Clin Res Ed) 1987 Apr 11;294(6577):940–942. doi: 10.1136/bmj.294.6577.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Williams A. Economics of coronary artery bypass grafting. Br Med J (Clin Res Ed) 1985 Aug 3;291(6491):326–329. doi: 10.1136/bmj.291.6491.326. [DOI] [PMC free article] [PubMed] [Google Scholar]

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