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Of the participants, 36% indicated male, 64% female, mean age was 44 years (SD=12.3); 12.3% of participants identified as Asian, 73.7% as white, 4.8% as black, 4.2% as Hispanic and 3.8% as other.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Survey items queried clinicians about knowledge, attitudes, comfort level, self-efficacy and challenges with screening and counselling AYA patients about marijuana, blunts, cigarettes, e-cigarettes, hookah and alcohol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were asked what percentage of their 10\u201317\u2009years old patients they screened for substance use. The median number of physicians reported screening 100% of their patients for cigarette (1st, 3rd quartiles; 80, 100) and alcohol use (75, 100) and 99.5% for marijuana use (50,100); for e-cigarettes, participants reported screening half of their patients and 0.0% (0, 50), (0, 75)) reported screening for hookah and blunts, respectively. On average (median), clinicians estimated that 15.0% of all 10\u201317\u2009years old patients smoked cigarettes, 10.0% used e-cigarettes, 20.0% used marijuana, 25.0% drank alcohol and 5.0% used hookah or blunts, respectively; yet they estimated lower than national rates of use of each product for their own patients. Clinicians reported greater comfort discussing cigarettes and alcohol with patients and less comfort discussing e-cigarettes, hookah, marijuana and blunts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identified low rates of screening and counselling AYA patients for use of e-cigarettes, hookahs and blunts by adolescent healthcare clinicians and points to potential missed opportunities to improve prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-059019","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T10:53:35Z","timestamp":1669114415000},"page":"e059019","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Cross-sectional online survey of clinicians\u2019 knowledge, attitudes and challenges to screening and counselling adolescents and young adults for substance use"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct01312480","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Anu L","family":"Gorukanti","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim S","family":"Kimminau","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Missouri Columbia, Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilary A","family":"Tindle","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA"},{"name":"Medicine, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan D","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Gorzkowski","sequence":"additional","affiliation":[{"name":"Department of Healthy Resilient Children Youth and Families, American Academy of Pediatrics, Itasca, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Kaseeska","sequence":"additional","affiliation":[{"name":"Department of Healthy Resilient Children Youth and Families, American Academy of Pediatrics, Itasca, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raabiah","family":"Ali","sequence":"additional","affiliation":[{"name":"Healthcare Settings Program, Chicago Department of Public Health, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lavisha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, NorthShore University HealthSystem, Evanston, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4922-2603","authenticated-orcid":false,"given":"Sean P","family":"David","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA"},{"name":"Department of Family Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonnie","family":"Halpern-Felsher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,11,22]]},"reference":[{"key":"2025121604234379000_12.11.e059019.1","unstructured":"Health Policy Institute . 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