APPENDIX A-6:

Primary Prevention in Young Adults and Adolescents

Suggested focused interventions for Primary Care providers to prevent initiation of tobacco use include the following:

Elementary School (through 6th grade):

1. Ask the child if he or she has experimented with tobacco.
2. Reinforce positive health choices.
3. Provide anticipatory guidance regarding the likelihood that he or she may encounter peers who use tobacco and discuss ways in which he or she might address peer pressure to try tobacco.

Middle School and High School (7 to 12th grade):

1. Reassure that most kids do not use tobacco.
2. Educate that all forms of tobacco (including snuff, cigarettes, dip, etc.) are equally dangerous and extremely addictive, and once you are hooked, it is very hard to quit.
3. Readdress issues of peer pressure.
4. Introduce the idea that addiction to tobacco takes away one’s independence.
5. Point out that tobacco use leads to:
   • Bad breath
   • Brittle and smelly hair
   • Smelly clothes
   • Stained teeth and finger nails
   • Stained and burned clothes
   • More colds, shortness of breath, and minor illnesses
   • Decreased athletic performance
   • Fire and deaths
6. Tobacco companies market to teenagers that smoking is rugged, sexy and cool. Eighty-five percent of all teenagers say they would prefer a boyfriend or girlfriend who does NOT smoke.
7. Addiction to nicotine may make a person more susceptible to trying other dangerous drugs.
8. The rule of 4s: There are over 4000 chemicals in every cigarette; 400 are toxic, at least 40 are known to cause cancer, and they are the same chemicals as are found in dead bodies (formaldehyde), moth balls or urinal cakes (naphthalene), gas chambers (hydrocyanide), fertilizer (phosphatides), and decaying fish (methylamine).