Resource Center: misc information materials, adolescents
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Patient Example: Amy's Fagerström Tolerance Questionnaire Results
This is a patient's response to the Fagerström Tolerance Questionnaire for Adolescents.
Name:
Amy Clark
Celebrities: Anti-Tobacco Websites
Tony Hawk (pro skateboarder) : http://www.cdc.gov/tobacco/youth/sports/posters/hawk/
Christy Turlington (model): http://www.cdc.gov/tobacco/youth/celebrities/christy/telly/
Youth Prevalence of Cigarette Use by Race/Ethnicity
This graph shows the 30 day prevalence of cigarette use among 8th, 10th and 12th graders (Johnston, et al.). Within this subgroup, prevalence is further divided by race/ethnicity.
Patient Example: Tamika's Tobacco Assessment Form
Tobacco Use Assessment Form for Children or Teens
Name: Tamika Jones
Date: 6/ 1 /2005
Have you ever smoked cigarettes or used any other tobacco product?
Responding to Marketing Questions
Marketing statements by tobacco companies are explained by the image they convey and their actual countermessage.
Adolescent Screen for Tobacco Dependence: The Hooked on Nicotine Checklist
Name: _______________________ Date: _____________________
1. Have you ever tried to quit but couldn’t? YES NO
Patient Example: Jennifer's Youth Tobacco Assessment Form
Name: Jennifer Simpson
Date: 6/ 1 /2005
Have you ever smoked cigarettes or used any other tobacco product?
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Topics
- addiction (3)
- brief interventions (1)
- individualized treatment (1)
- screening and diagnosis (1)


