Do health care providers offer advice to adolescents about nicotine-containing product use?

10530 Background: Use of tobacco and other nicotine-containing products is a major preventable cause of cancer. Most individuals initiate nicotine product use during adolescence. Advice from health care providers is important to decrease nicotine product initiation and encourage cessation among individuals using these products. It is unclear how frequently providers offer this advice to adolescent patients. We analyzed national survey data to better understand provider interactions with adolescents about nicotine product use. Methods: We analyzed data from 16,120 U.S. middle- and high-school students (weighted to represent a population of 21,836,206) who saw a health care provider (doctor, dentist, or nurse) in the past 12 months and had non-missing data on nicotine product use, family affluence level, and receipt of provider advice regarding nicotine product use from the 2021 National Youth Tobacco Survey (NYTS), a school-based, self-administered survey. Nicotine product use was determined from responses to 13 NYTS questions on use of tobacco or nicotine-containing products; those who indicated use of any products in the past 30 days were classified as “current users”. Receipt of advice was assessed from 3 questions on advice to not use cigarettes, e-cigarettes, or other nicotine-containing products during health care provider visits. Family affluence was based on 4 questions on family vacations, cars, computers, and bedrooms. Multivariable logistic regression analyses examined associations of receipt of advice with sociodemographic characteristics separately for current and non-current users, controlling for whether providers asked about nicotine product use adjusting for the complex survey design of the NYTS. Results: Of the sample, 1262 (weighted 7.9%) currently used nicotine products. Current users were significantly (p < 0.05) more likely to be older, female, and non-Hispanic White (vs. non-Hispanic Asian or Hispanic); 51.3% of current users vs. 44.0% of non-current users received health care provider advice. Among current users, older students were less likely to receive advice (odds ratio [OR] 0.85 per year of age, 95% confidence interval [CI] 0.77-0.93) while males (vs. females) were more likely to receive advice (OR 2.51, 95% CI 1.64-3.86). Among non-current users, older students were less likely to receive advice (OR 0.91, 95% CI 0.89-0.94). Males vs. females (OR 1.54, 95% CI 1.42-1.68); non-Hispanic Blacks vs. non-Hispanic Whites (OR 1.18, 95% CI 1.03-1.36); and those from highly affluent families (OR 1.20, 95% CI 1.06-1.36) were more likely to receive advice. Conclusions: Only half of adolescents received nicotine product use advice from health care providers. Those more likely to use nicotine products (older, female, non-Hispanic White students) were less likely to receive advice. Increased provider advice targeting at-risk populations may help decrease adolescent nicotine product use.