Screening and counseling for youth tobacco use in primary care settings in the United States: A scoping review

Objective
This scoping review examined healthcare providers’ (HCPs) screening and counseling for youth tobacco use in primary care settings in the United States, assessing rates, practices, and implementation barriers and facilitators.

Methods
The Joanna Briggs Institute methodology was followed. Searches were conducted across PubMed, Web of Science, EBSCO, and ABI/INFORM databases to identify studies published from 2014 to 2023. Data were analyzed using descriptive statistics and content analysis.

Results
Of the 655 studies retrieved, 22 met the inclusion criteria. HCPs reported screening and counseling youth for tobacco use more frequently than youth reported receiving these services. Screening and counseling for e-cigarette and other non-cigarette tobacco use was infrequent. Provision of screening and counseling by HCP and receipt by youth varied by age, gender, race/ethnicity, and tobacco use behaviors. Common practices included direct questioning and motivational interviewing. Barriers included low HCP self-efficacy, limited e-cigarette knowledge, perceived low effectiveness of tobacco use counseling, time constraints, and few referral options. Facilitators included HCP training, enhancements to electronic health records, and ensuring confidentiality.

Conclusions
Many opportunities to screen and counsel youth for tobacco use are missed in primary care settings. Addressing barriers and leveraging facilitators could improve service delivery and prevent youth tobacco use.

KEYWORDS:
Barriers; healthcare providers; screening and counseling; tobacco; youth