Adolescence marks a developmental period in which there are increases in experimentation [1] and regular use of tobacco [2]. An estimated 5,700 people per day initiated smoking cigarettes in 2013 [3]. Adolescents (12–17 years) accounted for half of all initiates in that year, and 7.8% of adolescents reported past 30-day tobacco product use [3]. Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued smoking [4–7]. Thus, tobacco prevention and cessation interventions may have a greater impact in adolescence than in adulthood when risk behaviors are more established. However, the proportion of past-year quit attempts among adolescent smokers decreased from 57.4% in 2001 to 48% in 2013 [8] suggesting that tobacco cessation efforts are not effectively reaching adolescent smokers.

Systematic reviews and meta-analyses of tobacco cessation interventions show that the more successful interventions consist of physicians and/or non-physicians engaged in one-on-one interactions as a means of tailoring efforts to the specific cessation needs of the smoker [9–11]. This individualized approach starts with identifying an individual’s smoking status. Screening patients for tobacco use allows physicians to identify the appropriate intervention - promoting quitting among current smokers, preventing relapse in former smokers, or encouraging never smokers to continue abstinence [12].

Physician screening for tobacco use increases the odds three-fold of physicians intervening with patients who smoke; However, without appropriate follow through by the physician, screening for tobacco use is not enough to significantly increase cessation rates [12]. The 2008 update to the U.S. Public Health Service Clinical Practice Guideline for Treating Tobacco Use and Dependence found it essential that physicians identify the tobacco use status of patients and intervene with all tobacco users identified [12]. Even brief physician advice lasting less than 3 min has resulted in a significant increase in quit rates among adult smokers compared to those who received no advice [12, 13].

Despite evidence supporting physician-based tobacco prevention and cessation interventions in adolescents, data from the 2011 National Youth Tobacco Survey shows only 20.8% of middle and high school students who visited a physician in the past 12 months were both screened for tobacco use and advised to quit [14]. Evidence suggests the rates of physician screening and advice to quit may differ among particular racial and ethnic groups. Data from the Memphis Health Project, a longitudinal study of smoking in adolescents in the mid-South, found that in a primarily African American sample of 11^th graders (82.9%), 28.9% of adolescents sampled were both screened for tobacco use and advised to quit by a physician [15].

To our knowledge, there is no recent data available on physician screening for tobacco use and advice to quit in a nationally representative sample of adolescents. Given the critical phase of development adolescence poses in tobacco use, and evidence that face-to-face interventions can improve smoking outcomes, this study used data from a recent national survey to examine physician tobacco use screening and advice to quit among adolescents who reported visiting a physician in the past 12 months.