Editor,—Routine anti-smoking advice from a physician has been shown to increase the cessation of smoking in adults by about two percentage points compared with controls.1 2However, to date, research using this approach has concentrated on adult smokers. We investigated the likely impact of an equivalent approach with adolescents. As young people are the least likely to use medical services,3 the intervention was in the form of an age-appropriate letter from a general practitioner.

Our intervention was directed at children of 12–14 years, an age when the rate of increase in regular smoking is highest.4Participants were 192 patients (101 boys (53%)) from five metropolitan general practices in Perth, Western Australia. On their birthday, participants were sent a personalised letter that combined a health message and birthday greeting. They were assigned randomly within age strata to receive either a letter on smoking or one on a control topic. The letters on smoking contained information about the dangers of smoking and the benefits of not smoking. The control …