Helping teens quit smoking with a motivational intervention


Giving up the cigarette habit is difficult to do. Can a 5A-s intervention help adolescents stop smoking?

In spite of the efforts of multiple organizations, many teenagers continue to smoke. Vaping, which was initially marketed as a safe way to help adults reduce their smoking, has not led to any reductions in adolescent smoking and previous research has actually indicated that vaping has resulted in more teenagers deciding to try out traditional smoking. A report in Pediatrics looks at the effectiveness of using a Public Health Service 5As-based clinician-delivered smoking cessation counseling intervention that used motivational tools in pediatric primary care practice.1

The researchers asked clinicians from 120 practices in the United States to participate in their study. They also recruited adolescents aged ≥14 years from the American Academy of Pediatrics Pediatric Research in Office Settings practice-based research network. The participating practices were randomly assigned to either training in smoking cessation, which was the intervention, or social media counseling, which was the attentional control. The teenagers completed confidential screening forms. A random sample of nonsmokers and self-reported smokers were given a chance to enroll in the study and were interviewed via the phone at 4 to 6 weeks, 6 months, and 12 months after the visits. Measures examined by the researchers included current tobacco use, cessation behaviors as well as intentions, and adolescents’ report of clinicians’ delivery of screening and counseling.

The clinicians who were trained in the 5As intervention were found to have delivered more screening (β = 1.0605, P < .0001) and counseling (β = 0.4354, P < .0001). In both the arms, the clinicians were found to screen smokers more often than nonsmokers. At 6 months, the study arm was not significantly linked with successful cessation. However, the smokers in the 5As group were found to be more likely to have quit at 12 months. Smokers who were addicted were counseled more often, regardless of the study arm, however, they were found to be less likely to successfully quit smoking.

Investigators concluded that adolescent smokers who were seen by clinicians trained in 5As were more likely to be screened for smoking and to receive counseling than teenagers who saw clinicians who weren’t trained. The smokers who saw trained clinicians were also more likely to make an attempt to quit. The intervention had limited ability to help teenagers remain abstinent from smoking. However, it is scalable and combining the intervention with other cessation techniques has a better possibility of improving the rate of quitting.


1. Klein J, Gorzkowski J, Resnick E, et al. Delivery and impact of a motivational intervention for smoking cessation: a PROS study. Pediatrics. September 30, 2020. Epub ahead of print. doi:10.1542/peds.2020-0644

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