Psychological Distress Levels and Youth Tobacco Screening and Advice by a Health Professional: National Youth Tobacco Survey, 2022

OBJECTIVE Rates of psychological distress (ie, depression, anxiety) among US youth have increased from 30% to 40% over the past decade. Youth experiencing psychological distress are more likely to use tobacco products, often as a coping mechanism. Health professionals can help prevent youth tobacco use through routine screening and counseling. This study examined whether youth with psychological distress were more likely to receive tobacco screening and advice not to use tobacco from a health professional. METHODS We analyzed data from the 2022 National Youth Tobacco Survey, focusing on 18 149 middle and high school students who reported visiting a health professional in the past year. Two primary outcomes were assessed: (1) receipt of tobacco screening and (2) receipt of advice not to use tobacco. Psychological distress was categorized as none, mild, moderate, or severe. Multivariable logistic regression models evaluated the association between distress level and each outcome, adjusting for demographics. We also tested for interaction between distress level and tobacco use. RESULTS Nearly half (47.6%) of youth reported some level of psychological distress. An estimated 48.9% of youth reported being screened for tobacco and 47.2% were advised not to use tobacco. Youth with distress were significantly more likely to be screened (odds ratio 1.20–1.42) than those without distress. However, distress was not associated with receiving advice. The association between distress and each outcome was not different for tobacco users and nonusers. CONCLUSION Health professionals need to improve screening and advising about tobacco, especially for youth reporting recent psychological distress.