world-no-tobacco-dayWe celebrated ‘World No Tobacco Day’ on May 31 and many of us may know that this year’s theme was to raise taxes on tobacco worldwide to discourage youth from starting to smoke. This shows worldwide concerns over tobacco use among adolescents and young people. Now, we have got good news yet again. The 2013 National Youth Risk Behavior Survey (YRBS) published by the Centers for Disease Control and Prevention reveals that cigarette smoking rates among high school students in the U.S. have dropped again than in 2009. The most interesting fact is that cigarette smoking among U.S. teens is at its lowest level after 22 years since the YBRS survey began. This survey related to pediatric healthcare is really encouraging for all smoking cessation programs conducted in the country.

According to the current CDC teen behavior survey, cigarette smoking among U.S. high school students has reduced to 15.7% in 2013, more than 2% decrease compared to levels in 2009 (18.1%). By reaching this teen smoking rate, the United States has fulfilled its national Healthy People 2020 objective of reducing cigarette use among adolescents to 16 percent or less. However, if we take a look at the YRBS surveys from 1991-2013, we can see the cigarette smoking rate has been continuously falling after 2005. This may be due to proliferation of mass media campaigns, affordable quit-smoking treatment, awareness programs and other control measures in the country. The low rate reported again in 2013 shows the effectiveness of such measures.

Though the survey points out significant progress in alleviating cigarette smoking among U.S. teens, reducing overall tobacco use still remains a considerable challenge. CDC data has shown the use of electronic cigarettes (e-cigarettes) and hookahs nearly doubled in certain cases between 2011 and 2012. YRBS survey also found no change in smokeless tobacco use among adolescents since 1999. Many teens use e-cigarettes as a way to quit regular cigarettes on the belief that they are safer than tobacco. However, a recent study by the University of California, San Francisco revealed e-cigarette is simply another way to nicotine addiction for teenagers. Apart from that, the YBRS survey found decline in cigar use has slowed down in recent years while current cigar use among male high school seniors is at 23 percent. In the opinion of healthcare experts, we should again invest in programs that will help them make choices that ensure a healthy life. Awareness programs regarding the harmful effects of e-cigarette are very essential.

Healthcare programs and control measures are not enough for banishing this curse from the society. Adolescents should take routine visits to their physician’s office to get advice for quitting tobacco use and good treatment. The American Academy of Pediatrics (AAP) policy statement has already advised pediatricians to become aware of adolescent alcohol, cigarette and other drug use trends and screen all adolescents for alcohol and drug use during health supervision and relevant acute care visits using appropriate screening tools and intervention strategies. Many pediatricians have concerns about the reimbursement for substance abuse screening and as a result drug addicted teens are missing this preventive care service. With the Affordable Care Act (ACA), these concerns have no place as alcohol and drug use assessments for adolescents are included in covered preventive care services and the insurers must provide coverage for such services since they come under essential health benefits. Pediatricians can receive the due reimbursement without any delay if they manage their revenue cycle properly.