Evidence for clinical smoking cessation for adolescents.

OBJECTIVE: This report reviews the evidence that informs the role of health and mental health care providers in addressing youth smoking cessation. DESIGN: Qualitative literature review. RESULTS: Physicians do not consistently screen adolescents for tobacco use and fail to provide recommended cessation advice. Challenges to addressing smoking cessation include the need for procedures to ensure confidentiality and the existence of competing demands to provide other services. Few published studies have specifically addressed the effectiveness of clinical interventions. Interventions that require return visits or follow-up phone contacts are technically difficult to implement in this population. Successful interventions may require resources not available in nonresearch settings. Most studies have used brief clinical intervention as a control condition, making it impossible to evaluate its effectiveness. CONCLUSION: There is little evidence that supports current clinical smoking cessation guidelines for adolescents. More research is needed to develop inexpensive, efficient clinical interventions that can provide youths access to smoking cessation help. Future challenges include reorganizing clinical systems to offer greater counseling by support staff or in electronic formats and to provide effective booster messages and follow-up care in a population that is difficult to track.     

The value of formative investment in organizational federations

Public goods theories highlight an incentive system that rewards ‘free riding’ on the contributions of early contributors toward collective actions. However, because such theories focus on creation of the good, they may underestimate returns that accrue to early contributors subsequent to the good's realization. The concept of formative investment is introduced here to describe the extent to which organizations help to create public goods such as interorganizational linkages like participatory federations. Data from the CEOs of 48 organizations involved in a participatory federation were used to assess how an organization's level of formative investment is related to later patterns of dependency and interaction among federation members. Findings suggest that from a long‐term perspective, and for goods that involve communication and interaction, the incentive structure may not be so favorable for free riders. To the extent that organizations with high formative investment have the capability to envision the future and communicate that vision to potential federation partners, they may be able to both reduce free riding and secure for themselves advantageous positions in the subsequent network of relations.