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New government guidelines recommend primary care doctors counsel children and teens not to start smoking. The U.S. Preventive Services Task Force concluded that prevention is more effective than trying to get youth to stop smoking once they’ve started.

Primary-care doctors should advise children and teens about the dangers of smoking, and how to avoid peer pressure to take up the habit, according to the guidelines. Reuters reports they are based on a review of studies that found 19 percent fewer children and teens started smoking after being exposed to prevention programs.

These programs did not have a high success rate—out of more than 26,000 youth in the studies, 50 would have to be counseled in order to prevent just one from starting to smoke over the next seven months to three years, the researchers report in the Annals of Internal Medicine.

“Ninety percent or so of smokers initiate smoking prior to (age) 18, so to really prevent smoking you have to address the teenage and older child population,” researcher Dr. David Grossman of the Group Health Research Institute and the University of Washington in Seattle told Reuters.

The task force last issued guidelines on youth and smoking in 2003. The earlier recommendations found there was not enough evidence about whether counseling could help prevent children and teens from starting to smoke, or help them quit.

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