Final Research Plan
Prevention and Cessation of Tobacco Use in Children and Adolescents: Primary Care Interventions
October 12, 2017
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
The final Research Plan is used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center. The resulting Evidence Review will form the basis of the USPSTF Recommendation Statement on this topic.
The draft Research Plan was available for comment from June 22 to July 19, 2017.
- Do primary care interventions to prevent tobacco and nicotine use or improve tobacco and nicotine cessation rates in children and adolescents improve health outcomes (i.e., respiratory, dental, cardiovascular, and oral health) and reduce the likelihood of tobacco and nicotine use in adulthood?
- Do primary care interventions prevent tobacco and nicotine use or improve tobacco and nicotine cessation rates in children and adolescents?
- What adverse effects are associated with primary care interventions to prevent tobacco and nicotine use or improve tobacco and nicotine cessation rates in children and adolescents?
The contextual question will not be systematically reviewed and is not shown in the Analytic Framework.
- What is the relationship between use of electronic nicotine delivery systems (ENDS) and use of tobacco products?
The Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Review. Criteria are overarching as well as specific to each of the key questions (KQs).
|Setting||Primary care, other health care, research clinic/office, dental clinic, or school-based health clinic||
|Condition||Tobacco use, nicotine use, or both, including cigarettes, smokeless tobacco, cigars, pipes, and ENDS (including electronic cigarettes)||Studies that target marijuana use only|
||Active intervention (more intensive than a single, brief contact per year or brief written materials)|
||Attitudes or knowledge about tobacco; intentions to quit|
|Study Design||KQs 1, 2:
|KQs 1–3: All other study designs
KQs 1, 2: Studies with less than 6 months (or 24 weeks) of followup postbaseline
|Study Quality||Fair- or good-quality studies||Poor-quality studies|
The draft Research Plan was posted on the USPSTF Web site from June 22 to July 19, 2017. In response to comments, the USPSTF made the following changes to the Research Plan. The USPSTF added pregnant adolescents as an included population, as well as studies in subgroups of adolescents with health problems common to primary care, such as depression and asthma. The USPSTF increased the upper age limit to 25 years for tobacco and nicotine use prevention (young adults ages 18 to 25 years are already included in a separate USPSTF recommendation statement advising behavioral and pharmacological intervention for tobacco cessation in adults). The USPSTF changed pharmacotherapy use for tobacco and nicotine cessation in children and adolescents from a contextual question to an included intervention (i.e., bupropion, varenicline tartrate, and nicotine replacement therapy) that will be reviewed systematically as part of the KQs. The USPSTF also included cardiovascular outcomes in addition to respiratory and oral/dental health outcomes.