Achieving Healthy People 2030 Goals for Adolescents

US Pharm. 2024;49(8):25-33.

ABSTRACT: Healthy People (HP) is a federal report released every 10 years that provides stakeholders with measurable public health objectives and tools to track the country’s progress in achieving these health goals. HP contains a set of objectives specific to the needs of adolescents. As public health advocates, pharmacists can help youth by addressing HP2030 objectives that reflect needs that have worsened over the past decade. Among these needs are preventive healthcare; skin cancer prevention; an elevated death rate; substance use issues; discrimination against lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual individuals; mental health issues; increased rates of gonorrhea; inadequate sleep; and resurgence of tobacco.

The CDC defines an adolescent as someone who is aged 12 to 17 years.¹ While the number of adolescents in the United States continues to grow, they will represent a decreasing percentage of the U.S. population as society ages. In 2016, there were approximately 41.7 million adolescents, representing 12.9% of the population. Projections indicate that by 2050, there will be 43.9 million adolescents, accounting for 11.3% of the population.²

What Is Healthy People 2030?

Healthy People (HP) 2030 (HP2030) is a federal initiative that dates back to a landmark report released in 1979 entitled Healthy People. Following the first HP report in 1990, these recommendations have been released every 10 years. They provide stakeholders with measurable public health objectives and tools to track the country’s progress in achieving these health goals.^3,4 As pharmacists become increasingly involved in public health, the objectives outlined in HP2030 can help guide their efforts.

For the HP2030 topic Adolescents (aged 12-17 years), there are 24 categories that include 100 objectives. Of these 100 objectives, 26 have become worse since the release of HP2020.⁵ This article will address selected adolescent objectives that have worsened over the past 10 years and delineate pharmacists’ interventions that may help to improve these outcomes.

Preventive Healthcare

HP2030 Objective AH-01 seeks to increase the proportion of adolescents who had a preventive healthcare visit in the past year. According to baseline data, 78.7% of adolescents aged 12 to 17 years received >1 preventive healthcare visits in the past 12 months in 2016-2017. However, this percentage decreased to 69.6% based on the most recent data from 2020-2021. The target for this objective is 82.6%.⁶

Preventive healthcare is an area in which pharmacists can have a significant impact. The Department of Health and Human Services Office of Population Affairs has provided recommendations for clinical preventive services for adolescents. These recommendations involve immunizations; screening tests for alcohol use, anxiety, blood pressure, cervical dysplasia as a precursor to cervical cancer, chlamydia and gonorrhea, depression and suicide risk, drug use, dyslipidemia, growth, hearing, hepatitis B, HIV, obesity, tuberculosis, and vision; and counseling and interventions for sexually transmitted infections (STIs), skin cancer, and tobacco use.⁷ 

Immunizations: The most up-to-date child and adolescent immunzation schedule can be found on the CDC’s Immunization Schedule webpage.⁸ Information on immunizations is provided by age, catch-up schedule, vaccine indications for certain medical conditions, special situations (e.g., travel), contraindications for use, and any new or updated comments from the Advisory Committee on Immunization Practices.⁸

Screenings: The screening test recommendations typically refer to those from the U.S. Preventive Services Task Force (USPSTF). Several recommendations are currently undergoing review, including screening for unhealthy alcohol use in adolescents and adults, screening and behavioral counseling interventions, cervical cancer, HIV, and obesity.^9-16

Final recommendation statements by the USPSTF include the following: Children and adolescents aged 8 to 18 years should be screened for anxiety; all sexually active women aged <24 years and women aged >25 years who are at increased risk of infection should be screened for chlamydia and gonorrhea; adolescents aged 12 to 18 years should be screened for major depressive disorder; and adolescents and adults at risk for infection should be screened for hepatitis B.^17-20 Screening recommendations for blood pressure and dyslipidemia as well as interventions for prevention of illicit drug use were less conclusive.^21-23 Other screening recommendations from the CDC pertain to height and hearing assessments and tuberculosis.^24-26

Counseling and Interventions: Pharmacists’ role in promoting preventive health services among adolescents has focused primarily on immunizations.^27-46 They are becoming more involved in providing STI screening services; however, services are geared toward adults.^47-50

To expand access to care, the CDC developed the HIV Testing in Retail Pharmacies training, which is designed to increase rapid, point-of-care testing in community pharmacies and retail clinics.^51,52 In October 2023, the National Association of County and City Health Officials, along with the National Alliance of State Pharmacy Associations, released a document outlining the pharmacist scope of practice related to preventing and treating STIs.⁵³ Additionally, the USPSTF recommends behavioral counseling for all sexually active adolescents and for adults at increased risk of STIs.^54,55

The CDC has recommended the use of pre-exposure prophylaxis (PrEP) as part of a comprehensive HIV prevention plan that includes discussing how to take PrEP as prescribed, proper condom use, screening for other STIs, and other risk-reduction methods. They advise to inform all sexually active adult and adolescent patients about PrEP and to prescribe PrEP to anyone who asks for it, including sexually active people who do not report HIV risk factors.⁵⁶

USPSTF also recommends counseling young adults, adolescents, children, and parents of young children on minimizing exposure to ultraviolet radiation, especially persons aged 6 months to 24 years with fair skin types, to reduce their risk of skin cancer.^57,58

The Campaign for Tobacco-Free Kids has a wealth of information to assist pharmacists in promoting smoking/vaping avoidance or cessation to youth.⁵⁹ Pharmacists can also train to be tobacco treatment specialists (TSS) through the Council for Tobacco Treatment Training Programs.⁶⁰

Skin Cancer

Reducing the proportion of students in grades 9 through 12 who report sunburn is the goal of HP2030 Objective C-10. According to baseline data, in 2017, 57.2% of students in grades 9 to 12 reported sunburn in the past 12 months. This incidence increased to 64.4%, however, based on the most recent data from 2021. The target for this objective is 52.2%.⁶¹

As medication experts, pharmacists can have a significant impact on reducing the risk of skin cancer by recommending appropriate sunscreens.⁶² Pharmacists can also counsel on the risk of drug-induced photosensitivity. Among the drugs that may be used by adolescents that can cause photosensitivity reactions are antibiotics, including tetracyclines and fluoroquinolones; antihistamines such as cetirizine, loratadine, and diphenhydramine; nonsteroidal anti-inflammatory agents; oral contraceptives and estrogens; and retinoids.^63-65 

Along with proper selection and application of sunscreen, pharmacists can also educate about the dangers of tanning salons.⁶⁶ Sunless tanning products contain dihydroxyacetone, which should not be inhaled, ingested, or applied to mucous membranes. Tanning pills contain the color additive canthaxanthin, which has been associated with liver injury, hives, and canthaxanthin retinopathy, a condition characterized by yellow deposits on the retina.⁶⁷

Death Rate

HP2030 Objective MICH-03 addresses reducing the rate of deaths in children and adolescents aged 1 to 19 years. According to baseline data, 25.2 deaths among children and adolescents aged 1 to 19 years per 100,000 population occurred in 2018. This statistic increased to 29.5 deaths per 100,000 in this age group based on data from 2021. The target for this objective is 18.4 deaths per 100,000 children and adolescents aged 1 to 19 years.⁶⁸

Drug overdoses and poisonings in children and adolescents increased by 83% from 2019 to 2020 and accounted for the third most common cause of death in this population. This was largely driven by the opioid crisis.^69,70 Pharmacists can take a leading role in helping to prevent opioid overdose deaths. Harm-reduction initiatives call for increased access to naloxone. In March 2023, naloxone was made available OTC.⁷¹ A free naloxone toolkit is available through the CDC.⁷²

Healthychildren.org provides medication safety tips for families, including information on protecting teens and children, safe storage of medications, use of safety prescription caps, and how to avoid unnecessary medications.⁷³ The FDA has a webpage with information on how to safely dispose of unwanted medications, including opioids.⁷⁴ It provides information on drug-takeback locations, which is the preferred method to discard medications, and it provides a FDA-approved list of flushable medications. Numerous opioids are on this flush list.⁷⁵ Nationwide Children’s has a video on an opioid safety protocol for the home, and it has identified four points to keep in mind when children and adolescents have been prescribed opioids. These include monitoring use; securing the prescription in a safe and out-of-reach location; transitioning the pediatric patient to a nonopioid as soon as possible; and safely disposing of unused medications.⁷⁶ Parents and caregivers should also be familiar with the National Poison Control Hotline number, which is 1-800-222-1222.⁷⁷  

Drug and Alcohol Use

Reducing the proportion of adolescents who used drugs in the past month is the focus of HP2030 Objective SU-05. According to baseline data in HP2030, in 2018, 8.0% of adolescents aged 12 to 17 years reported use of illicit drugs in the past 30 days. This number increased to 8.7%, according to data from 2019. The target of this objective is 5.5%.⁷⁸

Pharmacists can play a major role in patient education about the risks of drug and alcohol use. The U.S. Drug Enforcement Agency’s campaign “One Pill Can Kill” highlights the dangers associated with experimentation and how just a one-time use of an illicit substance that is contaminated with fentanyl can be fatal.⁷⁹ This website has a wealth of information educating teens, parents, and caregivers on the topic, including a partner toolbox.⁸⁰

The Substance Abuse and Mental Health Services Administration (SAMHSA) has substance use prevention resources available for youth and college students that pharmacists can utilize for patient education.^81,82

HP2030 Objective SU-06 addresses the proportion of adolescents who used marijuana in the past month. According to baseline data, 6.7% of adolescents aged 12 to 17 years reported marijuana use in the past 30 days in 2018. This percentage increased to 7.4% in 2019. The target for this objective is 5.8%.⁸³ The CDC stated that in 2022, 30.7% of 12th graders reported using cannabis in the past year, and 6.3% reported using cannabis daily in the past 30 days.⁸⁴ 

With the legalization of medicinal and recreational marijuana in numerous states, cannabis use is becoming normalized as the perceived risk of harm is reduced.^85,86 There is increasing concern over the development of cannabis use disorder, which occurs in about 17% of youths who use marijuana. Risks of cannabis use during adolescence include impairment of brain-maturation processes and attention, concentration, decision-making, impulsivity, and working memory; negative impact on driving; and reduced academic success. Additionally, a growing body of literature is associating cannabis use with psychosis and violent behavior, as well as the development of new-onset schizophrenia.^87-102 Other problem areas are the use of cannabis edibles and delta-8 THC among youth.^103,104

Evidence has found that by educating adolescents about the harms associated with cannabis use, an increase in both knowledge and the perception of risk of cannabis may result in lower levels of current and future use.¹⁰⁵  

One way that pharmacists can help address substance use and mental health disorders is by being trained in screening, brief interventions, and referral to treatment (SBIRT).^106,107 Detailed information about SBIRT training can be found on the SAMHSA website.¹⁰⁸

LgbtQ+ Community

HP2030 Objective LGBT-07 strives to reduce the proportion of lesbian, gay, or bisexual high school students who have used illicit drugs. According to baseline data, 23.1% of sexual minority students in grades 9 through 12 reported that they had ever used illicit drugs in their lifetime in 2017. This percentage increased to 27.8% in 2019. The target for this objective is 16.1%.¹⁰⁹

The Trevor Project, the leading suicide prevention and crisis intervention nonprofit organization for lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more (LGBTQ+) young people, examined substance use among LGBTQ+ youth. Experiencing conversion therapy was associated with significantly more youth reporting regular alcohol, marijuana, or prescription drug misuse.¹¹⁰

Pharmacists can work with local groups such as the National Alliance of Mental Illness or the Stigma-Free Mental Health Society to help promote awareness, understanding, and acceptance of sexual minority groups.^111,112 Pharmacists can become Youth Mental Health First Aid–certified, which is an evidence-based, early-intervention course that teaches participants about mental health and substance-use challenges of youth. They can also undergo SBIRT training to help assist their young LGBTQ+ patients.^108,113

Mental Health and Mental Disorders

HP2030 Objective MHMD-02 seeks to reduce suicide attempts by adolescents. According to baseline data in HP2030, 7.4 suicide attempts per 100 population of students in grades 9 through 12 occurred in the past 12 months as reported in 2017. This number increased to 10.2 suicide attempts per 100 population in 2021. The target for this objective is 1.8 suicide attempts per 100 population of students in grades 9 through 12 in the past 12 months.¹¹⁴

In January 2024, the American Academy of Pediatrics (AAP) released a clinical report on suicide and suicide risk in adolescents. It stated that suicide is the second-leading cause of death among youth aged 10 to 24 years.¹¹⁵ Recently, a National State of Emergency in Children’s Mental Health was issued by the AAP, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association. It includes guidance for pediatricians and pediatric healthcare providers.¹¹⁶ Additionally, a joint initiative of the AAP and the American Foundation for Suicide Prevention called “Advocacy and Policy Priorities for Youth Suicide Prevention” was published in 2023.¹¹⁷

The Trevor Project released data from the 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People, which showed that this group has a higher risk of suicide. Bullying, feeling discriminated against, and the threat of conversion therapy increased suicidal risk.¹¹⁸ In addition, there has also been an alarming increase in the rate of suicide among black youth aged 10 to 24 years.¹¹⁹

Pharmacists should educate about the 988 Lifeline, which is a national network of local crisis centers funded through SAMHSA that provides free and confidential emotional support 24 hours a day, 7 days a week to people in suicidal crisis or emotional distress.¹²⁰

Pharmacists are mandated reporters of child abuse and neglect. They have a vital role in identifying and reporting child abuse.^121,122 Pharmacists should educate themselves on the role that adverse childhood experiences may have on suicide risk.¹¹⁶ Mental Health First Aid and SBIRT training are helpful to address the mental health needs of this population.^108,113

Sexually Transmitted Infections, Gonorrhea

HP2030 Objective STI-02 stipulates to reduce gonorrhea rates in male adolescents and young men. According to baseline data, 523.5 cases of gonorrhea per 100,000 males aged 15 to 24 years were reported in 2017. This number increased to 598.6 cases of gonorrhea per 100,000 males aged 15 to 24 years in 2020. The target for this objective is 471.2 cases of gonorrhea per 100,000 males aged 15 to 24 years.¹²³ (At press time, HP2030 STI-02 data were based on information from 2020, which resulted in a classification of “getting worse.” However, when 2021 data were assessed, this indicator is now labeled “little or no detectable change.”)

Pharmacists can play a role by supporting a nonstigmatizing, comprehensive approach to sexual health education and sexual well-being; increasing awareness of STI testing among adolescents; vaccinating against human papillomavirus; and counseling about the risk of HIV and use of barrier contraception (i.e., condoms) for youth who choose to engage in sexual behaviors.¹²⁴ 

In July 2021, the CDC released its STI treatment guidelines. Pharmacists should be familiar with these guidelines, as they specifically address the management of gonococcal infections among adolescents.¹²⁵

Sleep

According to baseline data in HP2030, 25.4% of students in grades 9 through 12 had sufficient sleep on an average school night in 2017. This percentage decreased to 22.7% in 2021. HP2030 Objective SH-04 relates to increasing the proportion of high school students who get enough sleep, and the target for this objective is 27.4%.¹²⁶

Inadequate sleep can adversely affect somatic health, psychological health, and academic performance as well as contribute to risk-taking behaviors.¹²⁷ Adolescents aged 13 to 18 years should get 8 to 10 hours of sleep per 24 hours.^128,129

Depending on the sleep disorder, interventions include nonpharmacologic strategies, such as promoting good sleep hygiene; use of a sleep diary and bright lights; and cognitive behavioral therapy. Melatonin may be administered as appropriate 4 to 6 hours prior to bedtime.¹³⁰

The use of melatonin in the U.S. has increased fourfold from 1999-2000 to 2017-2018 and has been accompanied by a 530% increase in poison center calls for pediatric exposures from 2012 to 2021. These exposures have accounted for 7% of all emergency department (ED) visits, or approximately 11,000 ED visits.¹³¹

On March 29, 2024, the Council for Responsible Nutrition issued two sets of voluntary guidelines impacting melatonin use, which include the use of child-deterrent packaging and precautions with the use of gummies related to choking hazards in young patients.^132,133

It was found that between 12.2% and 19.4% of pediatric patients aged 9 to 16 years have used melatonin.^134,135 While melatonin use in children and adolescents appears to be associated with nonserious adverse events, much is still unknown about the use of this dietary supplement in this age group, especially with regard to the long-term effects, as it is a hormonal agent.¹³⁶ Taking melatonin introduces the practice of taking a medication for sleep, which may have unintended future consequences.¹³⁷ The American Academy of Sleep Medicine issued a health advisory regarding the use of melatonin in children and adolescents.¹³⁸

Parents are advised to practice sleep hygiene (e.g., removing electronic devices 1 hour prior to bedtime, setting a bedtime routine) prior to the use of melatonin; discuss the use of melatonin with a healthcare provider before initiating therapy; and limit the dietary supplement to occasional use. They should also be aware that these products are not regulated by the FDA and may contain contaminants or sub- or superpotencies.^129,139,140

Pharmacists can screen adolescents’ medication profiles for drugs that may adversely affect sleep and should educate parents about sleep hygiene, the use of nonpharmacologic interventions, and limiting melatonin to occasional use unless advised otherwise by their physician.^140-144 Pharmacists can also counsel on age-appropriate dosing of melatonin (i.e., 1 mg-2 mg daily for those aged 5 years; 1 mg-3 mg for those aged 6-12 years; and 1 mg-5 mg for those >13 years), always starting at the lowest dosage.¹⁴⁰

Tobacco Use

HP2030 Objective TU-04 addresses reducing current tobacco use in adolescents. According to baseline data in HP2030, 18.3% of students in grades 6 through 12 used cigarettes, electronic cigarettes (e-cigarettes), cigars, smokeless tobacco, a hookah pipe, pipe tobacco, and/or bidis in the past 30 days in 2018. This percentage increased to 23.0% in 2019. The target for this objective is 11.3%.¹⁴⁵

After decades of progress in preventing youth tobacco use, ground was lost with the advent of e-cigarettes.¹⁴⁶ Starting in 2014, e-cigarettes became the most used tobacco products in this age group and evolved to epidemic status by 2018. These products may contain heavy metals, volatile organic compounds, and fine and ultrafine particles, and they may lead to lifetime tobacco addiction.¹⁴⁷ 

The AAP issued a policy statement on protecting children and adolescents from tobacco and nicotine. It addresses the problem of e-cigarettes and alternative nicotine-delivery methods used by youth. It contains 15 policy recommendations to combat this problem.¹⁴⁸

Pharmacists can educate young smokers that help is available. According to smokefree.gov, all states have quit lines with counselors who are specifically trained to help smokers quit. Calling 800-QUIT-NOW (800-784-8669) will connect patients directly to their state’s quitline. Another resource is from the National Cancer Institute (NCI). Their hotline number is 877-44U-QUIT (877-448-7848). The NCI has trained counselors who provide information and support for quitting in English and Spanish from Monday through Friday from 9:00 a.m. to 9:00 p.m. Eastern time.¹⁴⁹ Smokefree.gov also has a Smoke-Free Teen webpage.¹⁵⁰

The AAP’s website, which was updated May 2024, recommends that nicotine replacement therapy (NRT)  can be an important tool for treating nicotine dependence in youth. However, many pediatricians are uncertain about how to use these products with adolescents, especially those aged <18 years. The AAP provides an “Information for Pediatricians” fact sheet to educate providers about NRT. It recommends that for best results, patients should be advised to pair a long-acting form of NRT (e.g., a patch) with a short-acting form (e.g., gum, lozenge, spray, or inhaler). Pharmacists can play an active role assisting both pediatricians and young patients in the selection and proper use of NRT products.¹⁵¹

Neither varenicline nor bupropion use is recommended for adolescents. Additionally, bupropion carries the boxed warning that antidepressants increase the risk of suicidal thoughts and behavior in adolescents and young adults in short-term-use trials.^152,153

Conclusion

As the most accessible healthcare providers in the community, pharmacists can play a major role in public health by improving the lives of their young patients and by addressing gaps in care as determined by HP2030.

REFERENCES

1. CDC. National Center for Health Statistics. Adolescent health. https://www.cdc.gov/nchs/fastats/adolescent-health.htm. Accessed July 12, 2024.
2. U.S. Department of Health and Human Services, Office of Population Affairs. America’s diverse adolescents. https://opa.hhs.gov/adolescent-health/adolescent-health-data/americas-diverse-adolescents. Accessed July 12, 2024.3. Healthy People 2030. Healthy People 2030 framework. https://health.gov/healthypeople/about/healthy-people-2030-framework. Accessed July 12, 2024.
4. Healthy People 2030. About Healthy People 2030. https://health.gov/healthypeople/about. Accessed July 12, 2024.
5. Healthy People 2030. Adolescents. https://health.gov/healthypeople/objectives-and-data/browse-objectives/adolescents. Accessed July 12, 2024.
6. Healthy People 2030. Adolescents. Increase the proportion of adolescents who had a preventive health care visit in the past year ― AH-01. https://health.gov/healthypeople/objectives-and-data/browse-objectives/adolescents/increase-proportion-adolescents-who-had-preventive-health-care-visit-past-year-ah-01. Accessed July 12, 2024.
7. Department of Health and Human Services, Office of Population Affairs. Recommended clinical preventive services for adolescents. https://opa.hhs.gov/adolescent-health/physical-health-developing-adolescents/clinical-preventive-services/recommended. Accessed July 12, 2024.
8. CDC. Child and adolescent immunization schedule by age. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. Accessed July 12, 2024.
9. U.S. Preventive Services Task Force. Unhealthy alcohol use in adolescents and adults: screening and behavioral counseling interventions. https://www.uspreventiveservicestaskforce.org/uspstf/draft-update-summary/unhealthy-alcohol-use-adolescents-adults-behavioral-counseling-interventions. Accessed July 12, 2024.
10. U.S. Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(18):1899-1909.
11. U.S. Preventive Services Task Force. Cervical cancer: screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Accessed July 12, 2024.
12. U.S. Preventive Services Task Force; Curry SJ, Krist A
13. U.S. Preventive Services Task Force. Human immunodeficiency virus (HIV) infection: screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Accessed July 12, 2024.
14. U.S. Preventive Services Task Force; Owens DK, Davidson KW, Krist AH, et al. Screening for HIV infection: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2019;321(23):2326-2336.
15. U.S. Preventive Services Task Force. Obesity in children and adolescents: screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/obesity-in-children-and-adolescents-screening. Accessed July 12, 2024.
16. U.S. Preventive Services Task Force; Grossman DC, Bibbins-Domingo K, Curry SJ, et al. Screening for obesity in children and adolescents: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2017;317(23):2417-2426.
17. U.S. Preventive Services Task Force; Mangione CM, Barry MJ, Nicholson WK, et al. Screening for anxiety in children and adolescents: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2022;328(14):1438-1444.
18. U.S. Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, et al. Screening for chlamydia and gonorrhea: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2021;326(10):949-956.
19. U.S. Preventive Services Task Force; Mangione CM, Barry MJ, Nicholson WK, et al. Screening for depression and suicide risk in children and adolescents: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2022;328(15):1534-1542.
20. U.S. Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et al. Screening for hepatitis B virus infection in adolescents and adults: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2020;324(23):2415-2422.
21. U.S. Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et al. Screening for high blood pressure in children and adolescents: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2020;324(18):1878-1883.
22. U.S. Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et al. Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2020;323(20):2060-2066.
23. U.S. Preventive Services Task Force; Barry MJ, Nicholson WK, Silverstein M, et al. Screening for lipid disorders in children and adolescents: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2023;330(3):253-260.
24. CDC. National Center for Health Statistics. Growth charts. https://www.cdc.gov/growthcharts/. Accessed July 12, 2024.
25. CDC. Screening for hearing loss. https://www.cdc.gov/hearing-loss-children/screening/index.html. Accessed July 12, 2024.
26. CDC. Testing for tuberculosis. https://www.cdc.gov/tb/testing/?CDC_AAref_Val=https://www.cdc.gov/tb/topic/testing/default.htm. Accessed July 12, 2024.
27. Fernandes A, Wang D, Domachowske JB, Suryadevara M. HPV vaccine knowledge, attitudes, and practices among New York State medical providers, dentists, and pharmacists. Hum Vaccin Immunother. 2023;19(2):2219185.
28. Koskan A, Vizcaino M, Brennhofer SA, et al. Human papillomavirus vaccine administration behaviors and influences among Arizona pharmacists and pharmacy interns. Hum Vaccin Immunother. 2021;17(9):3090-3095.
29. Dufour L, Carrouel F, Dussart C. Human papillomaviruses in adolescents: knowledge, attitudes, and practices of pharmacists regarding virus and vaccination in France. Viruses. 2023;15(3):778.
30. Paulsen MR, Patel NR, Sulis C, et al. Human papillomavirus, herpes zoster, and hepatitis B vaccinations in immunocompromised patients: an update for pharmacists. J Pharm Pract. 2021;34(6):943-951.
31. McCauley LM, Lake LM, Madison NR, et al. Pharmacist and pharmacy intern perceptions of adolescent vaccination administration. J Am Pharm Assoc (2003). 2020;60(3S):S7-S12.e1.
32. Della Polla G, Napolitano F, Pelullo CP, et al. Investigating knowledge, attitudes, and practices regarding vaccinations of community pharmacists in Italy. Hum Vaccin Immunother. 2020;16(10):2422-2428.
33. Sivaraman V, Wise KA, Cotton W, et al. Previsit planning improves pneumococcal vaccination rates in childhood-onset SLE. Pediatrics. 2020;145(1):e20183141.
34. Burman C, Alderfer J, Snow VT. A review of the immunogenicity, safety and current recommendations for the meningococcal serogroup B vaccine, MenB-FHbp. J Clin Pharm Ther. 2020;45(2):270-281.
35. Koskan AM, Dominick LN, Helitzer DL. Rural caregivers' willingness for community pharmacists to administer the HPV vaccine to their age-eligible children. J Cancer Educ. 2021;36(1):189-198.
36. Teeter BS, Mosley C, Thomas JL, et al. Improving HPV vaccination using implementation strategies in community pharmacies: pilot study protocol. Res Social Adm Pharm. 2020;16(3):336-341.
37. Islam JY, Gruber JF, Kepka D, et al. Pharmacist insights into adolescent human papillomavirus vaccination provision in the United States. Hum Vaccin Immunother. 2019;15(7-8):1839-1850.
38. Fava JP, Stewart B, Dudzinski KM, et al. Emerging topics in vaccine therapeutics for adolescents and adults: an update for immunizing pharmacists. J Pharm Pract. 2020;33(2):192-205.
39. Shah PD, Trogdon JG, Golden SD, et al. Impact of pharmacists on access to vaccine providers: a geospatial analysis. Milbank Q. 2018;96(3):568-592.
40. Shah PD, Calo WA, Marciniak MW, et al. Service quality and parents’ willingness to get adolescents HPV vaccine from pharmacists. Prev Med. 2018;109:106-112.
41. Breitbach AA, Jenn CA, Milavetz G. Distraction techniques for immunizations in children and adolescents. J Am Pharm Assoc (2003). 2017;57(3):414-415.
42. Wise KA, Sebastian SJ, Haas-Gehres AC, et al. Pharmacist impact on pediatric vaccination errors and missed opportunities in the setting of clinical decision support. J Am Pharm Assoc (2003). 2017;57(3):356-361.
43. Isenor JE, Alia TA, Killen JL, et al. Impact of pharmacists as immunizers on influenza vaccination coverage in Nova Scotia, Canada. Hum Vaccin Immunother. 2016;12(5):1225-1228.
44. Shah PD, Calo WA, Marciniak MW, et al. Service quality and parents’ willingness to get adolescents HPV vaccine from pharmacists. Prev Med. 2018;109:106-112.
45. Trogdon JG, Shafer PR, Shah PD, Calo WA. Are state laws granting pharmacists authority to vaccinate associated with HPV vaccination rates among adolescents? Vaccine. 2016;34(38):4514-4519.
46. Elliott JP, Harrison C, Konopka C, et al. Pharmacist-led screening program for an inner-city pediatric population. J Am Pharm Assoc (2003). 2015;55(4):413-418.
47. Wood H, Gudka S. Pharmacist-led screening in sexually transmitted infections: current perspectives. Integr Pharm Res Pract. 2018;7:67-82.
48. Deppe SJ, Nyberg CR, Patterson BY, et al. Expanding the role of a pharmacist as a sexually transmitted infection provider in the setting of an urban free health clinic. Sex Transm Dis. 2013;40(9):685-688.
49. Gudka S, Marshall L, Creagh A, Clifford RM. To develop and measure the effectiveness and acceptability of a pharmacy-based chlamydia screening intervention in Australia. BMJ Open. 2013;3(8):e003338.
50. Kelly DV, Kielly J, Hughes C, et al. Expanding access to HIV testing through Canadian community pharmacies: findings from the APPROACH study. BMC Public Health. 2020;20(1):639.
51. CDC. HIV testing in retail pharmacies. https://www.cdc.gov/hiv/effective-interventions/diagnose/hiv-testing-in-retail-pharmacies/index.html#print. Accessed July 12, 2024.
52. CDC. Implementing HIV testing in nonclinical settings: a guide for HIV testing providers. March 2, 2016. https://www.cdc.gov/hiv/pdf/testing/CDC_HIV_Implementing_HIV_Testing_in_Nonclinical_Settings.pdf. Accessed July 12, 2024.
53. NACCHO and NASPA. Pharmacist scope of practice related to preventing and treating STIs. October 26, 2023. https://www.naccho.org/uploads/downloadable-resources/PharmacistScopeofPracticeReport.pdf. Accessed July 12, 2024.
54. U.S. Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, et a;. Behavioral counseling interventions to prevent sexually transmitted infections: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2020;324(7):674-681.
55.U.S. Preventive Services Task Force. Final recommendation statement: sexually transmitted infections: behavioral counseling. August 18, 2020. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/sexually-transmitted-infections-behavioral-counseling. Accessed July 12, 2024.
56. CDC. Clinical guidance for PrEP. https://www.cdc.gov/hivnexus/hcp/prep/index.html#:~:text=PrEP%20is%20the%20use%20of,administration%20to%20meet%20patients'%20needs. Accessed July 7, 2024.
57. U.S. Preventive Services Task Force; Grossman DC, Curry SJ, Owens DK, et al. Behavioral counseling to prevent skin cancer: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(11):1134-1142.
58. U.S. Preventive Services Task Force. Final Recommendation Statement. Skin cancer prevention: behavioral counseling. March 20, 2018. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/skin-cancer-counseling. Accessed July 12, 2024.
59. Campaign for Tobacco-Free Kids. Get the facts. Fact sheets. https://www.tobaccofreekids.org/protectkids/get-the-facts. Accessed July 12, 2024.
60. Council for Tobacco Treatment Training Programs. https://www.ctttp.org/. Accessed July 12, 2024.
61. Healthy People 2030. Adolescents. Reduce the proportion of students in grades 9 through 12 who report sunburn ― C-10. https://health.gov/healthypeople/objectives-and-data/browse-objectives/cancer/reduce-proportion-students-grades-9-through-12-who-report-sunburn-c-10. Accessed July 12, 2024.
62. Levine L. Sunscreen safety: what every pharmacist needs to know. May 14, 2024. Drug Topics. https://www.drugtopics.com/view/sunscreen-safety-what-every-pharmacist-needs-to-know. Accessed July 12, 2024.
63. FDA. The sun and your medicine. https://www.fda.gov/drugs/special-features/sun-and-your-medicine. Accessed July 12, 2024.
64. Lau LDW, Vu M, Scardamaglia L. Drug-induced photosensitivity. DermNet. https://dermnetnz.org/topics/drug-induced-photosensitivity. Accessed July 12, 2024.
65. Blakely KM, Drucker AM, Rosen CF. Drug-induced photosensitivity−an update: culprit drugs, prevention and management. Drug Saf. 2019;42(7):827-847.  
66. Basch CH, Basch CE, Rajan S, Ruggles KV. Use of sunscreen and indoor tanning devices among a nationally representative sample of high school students, 2001-2011. Prev Chronic Dis. 2014;11:E144.
67. FDA. Tanning products. https://www.fda.gov/radiation-emitting-products/tanning/tanning-products. Accessed July 12, 2024.
68. Healthy People 2030. Adolescents. Reduce the rate of deaths in children and adolescents aged 1-19 years ― MICH-03. https://health.gov/healthypeople/objectives-and-data/browse-objectives/children/reduce-rate-deaths-children-and-adolescents-aged-1-19-years-mich-03. Accessed July 12, 2024.
69. Goldstick JE, Cunningham RM, Carter PM. Current causes of death in children and adolescents in the United States. N Engl J Med. 2022;386(20):1955-1956.
70. CDC, National Center for Health Statistics. National Vital Statistics System, Mortality 2018-2022 on CDC WONDER Online Database, released in 2024. Data are from the Multiple Cause of Death Files, 2018-2022, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. http://wonder.cdc.gov/ucd-icd10-expanded.html. Accessed May 29, 2024.
71. FDA. FDA approves first over-the-counter naloxone nasal spray. March 29, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray. Accessed July 12, 2024.
72. CDC. Overdose prevention. Naloxone toolkit. https://www.cdc.gov/overdose-prevention/hcp/toolkits/naloxone.html. Accessed July 12, 2024.
73. Healthychildren.org. Medication safety tips for families. https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Medication-Safety-Tips.aspx. Accessed July 7, 2024.
74. FDA. Disposal of unused medicines: what you should know. https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know. Accessed July 7, 2024.
75. FDA. Drug disposal: FDA’s flush list for certain medicines. https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-fdas-flush-list-certain-medicines#FlushList. Accessed July 7, 2024.
76. Nationwide Children’s. Opioid safety. https://www.nationwidechildrens.org/specialties/comprehensive-pain-management-clinic/pain-treatment-therapy-options/opioid-safety. Accessed July 7, 2024.
77. National Poison Control Center. Get help online or by phone. https://www.poison.org/. Accessed July 7, 2024.
78. Healthy People 2030. Adolescents. Reduce the proportion of adolescents who used drugs in the past month ―SU-05. https://health.gov/healthypeople/objectives-and-data/browse-objectives/drug-and-alcohol-use/reduce-proportion-adolescents-who-used-drugs-past-month-su-05. Accessed July 12, 2024.
79. U.S. Drug Enforcement Administration. One Pill Can Kill. https://www.dea.gov/onepill. Accessed July 12, 2024.
80. U.S. Drug Enforcement Administration. One Pill Can Kill. Partner toolbox. https://www.dea.gov/onepill/partner-toolbox. Accessed July 12, 2024. 
81. Substance Abuse and Mental Health Services Administration. About us. https://www.samhsa.gov/about-us. Accessed July 12, 2024.  
82. Substance Abuse and Mental Health Services Administration. Substance use prevention resources for youth and college students. https://www.samhsa.gov/prevention-week/voices-of-youth/substance-use-prevention-resources-youth-college-students. Accessed July 12, 2024.
83. Healthy People 2030. Adolescents. Reduce the proportion of adolescents who used marijuana in the past month ― SU-06. https://health.gov/healthypeople/objectives-and-data/browse-objectives/drug-and-alcohol-use/reduce-proportion-adolescents-who-used-marijuana-past-month-su-06. Accessed July 12, 2024.
84. CDC. Cannabis and public health. Cannabis and teens. https://www.cdc.gov/cannabis/health-effects/cannabis-and-teens.html#:~:text=In%202022%2C%2030.7%25%20of%2012,with%20regular%20or%20heavy%20use. Accessed July 12, 2024.
85. Mariani AC, Williams AR. Perceived risk of harm from monthly cannabis use among U.S. adolescents: National Survey on Drug Use and Health, 2017. Prev Med Rep. 2021;23:101436.
86. Reboussin BA, Wagoner KG, Sutfin EL, et al. Trends in marijuana edible consumption and perceptions of harm in a cohort of young adults. Drug Alcohol Depend. 2019;205:107660.
87. Ladegard K, Thurstone C, Rylander M. Marijuana legalization and youth. Pediatrics. 2020;145(Suppl 2):S165-S174.
88. Albaugh MD, Ottino-Gonzalez J, Sidwell A, et al; IMAGEN Consortium. Association of cannabis use during adolescence with neurodevelopment. JAMA Psychiatry. 2021;78(9):1–11.
89. Jacobus J, Bava S, Cohen-Zion M, et al. Functional consequences of marijuana use in adolescents. Pharmacol Biochem Behav. 2009;92(4):559-565.
90. Volkow ND, Compton WM, Blanco C, et al. Associations of cannabis use, use frequency, and cannabis use disorder with violent behavior among young adults in the United States. Int J Drug Policy. 2024;128:104431.
91. Miller NS, Ipeku R, Oberbarnscheidt T. A review of cases of marijuana and violence. Int J Environ Res Public Health. 2020;17(5):1578.
92. Chandy M, Nishiga M, Wei TT, et al. Adverse impact of cannabis on human health. Annu Rev Med. 2024;75:353-367.
93. Baldaçara L, Ramos A, Castaldelli-Maia JM. Managing drug-induced psychosis. Int Rev Psychiatry. 2023;35(5-6):496-502.
94. Au RT, Hotham E, Suppiah V. Guidelines and treatment for illicit drug related presentations in emergency departments: a scoping review. Australas Psychiatry. 2023;31(5):625-634.
95. Carvalho C, Vieira-Coelho MA. Cannabis induced psychosis: a systematic review on the role of genetic polymorphisms. Pharmacol Res. 2022;181:106258.
96. Hinckley J, Bhatia D, Ellingson J, et al. The impact of recreational cannabis legalization on youth: the Colorado experience. Eur Child Adolesc Psychiatry. 2024;33(3):637-650.
97. Stark T, Di Martino S, Drago F, et al. Phytocannabinoids and schizophrenia: focus on adolescence as a critical window of enhanced vulnerability and opportunity for treatment. Pharmacol Res. 2021;174:105938.
98. De Faria L, Mezey L, Winkler A. Cannabis legalization and college mental health. Curr Psychiatry Rep. 2021;23(4):17.
99. Tirado-Muñoz J, Lopez-Rodriguez AB, Fonseca F, et al. Effects of cannabis exposure in the prenatal and adolescent periods: preclinical and clinical studies in both sexes. Front Neuroendocrinol. 2020;57:100841.
100. Pearson NT, Berry JH. Cannabis and psychosis through the lens of DSM-5. Int J Environ Res Public Health. 2019;16(21):4149.
101. Sideli L, Quigley H, La Cascia C, Murray RM. Cannabis use and the risk for psychosis and affective disorders. J Dual Diagn. 2020;16(1):22-42.
102. Roberts BA. Legalized cannabis in Colorado emergency departments: a cautionary review of negative health and safety effects. West J Emerg Med. 2019;20(4):557-572.
103. Lisi DM. Cannabis edibles and pediatric toxicity. U.S. Pharm. 2022;47(8):HS2-HS11.
104. FDA. 5 things to know about delta-8 tetrahydrocannabinol − delta-8 THC. https://www.fda.gov/consumers/consumer-updates/5-things-know-about-delta-8-tetrahydrocannabinol-delta-8-thc. Accessed July 12, 2024.
105. Harrison ME, Kanbur N, Canton K, et al. Adolescents' cannabis knowledge and risk perception: a systematic review. J Adolesc Health. 2024;74(3):402-440.
106. Shonesy BC, Williams D, Simmons D, et al. Screening, brief intervention, and referral to treatment in a retail pharmacy setting: the pharmacist’s role in identifying and addressing risk of substance use disorder. J Addict Med. 2019;13(5):403-407.
107. Cloutier RM, Talbert A, Weidman J, Pringle JL. Project lifeline: implementing SBIRT in rural pharmacies to address opioid overdoses and substance use disorder. Am J Drug Alcohol Abuse. 2023;49(4):406-417.
108. Substance Abuse and Mental Health Services Administration. Screening, brief intervention, and referral to treatment (SBIRT). https://www.samhsa.gov/sbirt. Accessed July 13, 2024.
109. Healthy People 2030. Reduce the proportion of lesbian, gay, or bisexual high school students who have used illicit drugs ― LGBT-07. https://health.gov/healthypeople/objectives-and-data/browse-objectives/lgbt/reduce-proportion-lesbian-gay-or-bisexual-high-school-students-who-have-used-illicit-drugs-lgbt-07. Accessed July 13, 2024.
110. Trevor Project. Research brief: substance use and suicide risk among LGBTQ youth. January 2022. https://www.thetrevorproject.org/wp-content/uploads/2022/01/Substance-Use-and-Suicide-Risk-Among-LGBTQ-Youth-Jan-22-Brief-DRAFT.pdf. Accessed July 12, 2024.
111. National Alliance on Mental Illness. Pledge to be stigma-free. https://www.nami.org/get-involved/pledge-to-be-stigmafree/. Accessed July 13, 2024.
112. Stigma-Free Society. Awareness, understanding, and acceptance. https://stigmafreementalhealth.com/. Accessed July 13, 2024.
113. National Council for Mental Wellbeing. Mental Health First Aid. https://www.mentalhealthfirstaid.org/. Accessed July 13, 2024.
114. Healthy People 2030. Reduce suicide attempts by adolescents − MHMD-02. https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders/reduce-suicide-attempts-adolescents-mhmd-02. Accessed July 12, 2024.
115. Hua LL, Lee J, Rahmandar MH, Sigel EJ; Committee on Adolescence; Council on Injury, Violence, and Poison Prevention. Suicide and suicide risk in adolescents. Pediatrics. 2024;153(1):e2023064800.
116. American Academy of Pediatrics. AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health. October 19, 2021. https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/. Accessed July 13, 2024.
117. American Academy of Pediatrics. Advocacy and policy priorities for youth suicide prevention. https://www.aap.org/en/patient-care/blueprint-for-youth-suicide-prevention/advocacy-and-policy-strategies-for-suicide-prevention/. Accessed July 12, 2024.
118. Nath R, Matthews DD, DeChants JP, et al. 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People. West Hollywood, CA: The Trevor Project. https://www.thetrevorproject.org/survey-2024/assets/static/TTP_2024_National_Survey.pdf.
119. Pappas S. More than 20% of teens have seriously considered suicide. Psychologists and communities can help tackle the problem. July 1, 2023. American Psychological Association. https://www.apa.org/monitor/2023/07/psychologists-preventing-teen-suicide#:~:text=More%20than%2020%25%20of%20teens%20have%20seriously%20considered%20suicide. Accessed July 13, 2024.
120. 988 Suicide and Crisis Lifeline. https://988lifeline.org/. Accessed July 12, 2024.
121. National Association of Mandated Reporters. 7 Professions with a duty to report all types of abuse. https://namr.org/news/7-professions-with-a-duty-to-report-all-types-of-abuse. Accessed July 13, 2024.
122. Ports KA, Merrick MT, Stone DM, et al. Adverse childhood experiences and suicide risk: toward comprehensive prevention. Am J Prev Med. 2017;53(3):400-403.
123. Healthy People 2030. Reduce gonorrhea rates in male adolescents and young men ― STI-02. https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-transmitted-infections/reduce-gonorrhea-rates-male-adolescents-and-young-men-sti-02. Accessed July 12, 2024.
124. U.S. Department of Health and Human Services. Sexually Transmitted Infections National Strategic Plan for the United States: 2021–2025. Washington, DC. 2020. https://www.hhs.gov/sites/default/files/STI-National-Strategic-Plan-2021-2025.pdf. Accessed July 13, 2024.
125. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(No. RR-4):1-187. 
126. Healthy People 2030. Increase the proportion of high school students who get enough sleep ― SH-04. https://health.gov/healthypeople/objectives-and-data/browse-objectives/sleep/increase-proportion-high-school-students-who-get-enough-sleep-sh-04. Accessed July 13, 2024.
127. Shochat T, Cohen-Zion M, Tzischinsky O. Functional consequences of inadequate sleep in adolescents: a systematic review. Sleep Med Rev. 2014;18(1):75-87.
128. CDC. CDC healthy schools: sleep in middle and high school students. https://www.cdc.gov/healthyschools/features/students-sleep.htm. Accessed July 13, 2024.
129. Suni E, Dimitriu A. Teens and sleep. October 4, 2023. https://www.sleepfoundation.org/teens-and-sleep. Accessed July 13, 2024.
130. Kansagra S. Sleep disorders in adolescents. Pediatrics. 2020;145(Suppl 2):S204-S209.
131. Freeman DI, Lind JN, Weidle NJ, et al. Notes from the field: emergency department visits for unsupervised pediatric melatonin ingestion - United States, 2019-2022. MMWR Morb Mortal Wkly Rep. 2024;73(9):215-217./
132. Council for Responsible Nutrition. Voluntary guidelines: Formulation, labeling, and packaging of melatonin-containing dietary supplements for sleep support. https://www.crnusa.org/sites/default/files/weekly/24-04-18/Voluntary-Guidelines_Melatonin_Approved-28March2024.pdf. Accessed July 12, 2024.
133. Council for Responsible Nutrition. Voluntary guidelines: Labeling of gummy dietary supplements. https://crnusa.org/regulation-legislation/self-regulation/gummy-labeling. Accessed July 13, 2024.
134. Hartstein LE, Garrison MM, Lewin D, et al. Characteristics of melatonin use among U.S. children and adolescents. JAMA Pediatr. 2024;178(1):91-93.
135. Sadikova E, Rakesh D, Tiemeier H. Patterns of melatonin use in a diverse national pediatric sample. JAMA Netw Open. 2024;7(5):e2412502.
136. Händel MN, Andersen HK, Ussing A, et al. The short-term and long-term adverse effects of melatonin treatment in children and adolescents: a systematic review and GRADE assessment. EClinicalMedicine. 2023;61:102083.
137. Marshall L, Goda N. Melatonin use soars among children, with unknown risks. CU Boulder Today. November 13, 2023.  https://www.colorado.edu/today/2023/11/13/melatonin-use-soars-among-children-unknown-risks. Accessed July 13, 2024.
138. American Academy of Sleep Medicine. Health Advisory: Melatonin use in children and adolescents. https://aasm.org/advocacy/position-statements/melatonin-use-in-children-and-adolescents-health-advisory/#:~:text=To%20address%20the%20safe%20use,a%20pediatric%20health%20care%20professional. Accessed July 13, 2024.
139. Esparham A. Melatonin for kids: what parents should know about this sleep aid. https://www.healthychildren.org/English/healthy-living/sleep/Pages/melatonin-and-childrens-sleep.aspx/. Accessed July 13, 2024.
140. Sleep Foundation. Melatonin for kids: a guide for parents and caregivers. https://www.sleepfoundation.org/melatonin/melatonin-for-children. Accessed July 12, 2024.
141. Van Gastel A. Drug-induced insomnia and excessive sleepiness. Sleep Med Clin. 2022;17(3):471-484.
142. Tobaiqy M, Stewart D, Helms PJ, et al. Parental reporting of adverse drug reactions associated with attention-deficit hyperactivity disorder (ADHD) medications in children attending specialist paediatric clinics in the UK. Drug Saf. 2011;34(3):211-219.
143. Faraone SV, Po MD, Komolova M, Cortese S. Sleep-associated adverse events during methylphenidate treatment of attention-deficit/hyperactivity disorder: a meta-analysis. J Clin Psychiatry. 2019;80(3):18r12210.
144. Tavassoli N, Montastruc-Fournier J, Montastruc JL; French Association of Regional Pharmacovigilance Centres. Psychiatric adverse drug reactions to glucocorticoids in children and adolescents: a much higher risk with elevated doses. Br J Clin Pharmacol. 2008;66(4):566-567.
145. Healthy People 2030. Reduce current tobacco use in adolescents ― TU-04. https://health.gov/healthypeople/objectives-and-data/browse-objectives/tobacco-use/reduce-current-tobacco-use-adolescents-tu-04. Accessed July 13, 2024.
146. Campaign for Tobacco-Free Kids. E-cigarettes are reversing progress in reducing youth tobacco use. December 29, 2020. https://www.tobaccofreekids.org/us-resources/fact-sheet/e-cigarettes-are-reversing-progress-in-reducing-youth-tobacco-use. Accessed July 13, 2024.  
147. National Cancer Institute. Cancer Trends Progress Report. Youth tobacco use. https://progressreport.cancer.gov/prevention/youth_smoking. Accessed July 13, 2024. 
148. Jenssen BP, Walley SC, Boykan R, et al; Section on Nicotine and Tobacco Prevention and Treatment; Committee on Substance Use and Prevention. Protecting children and adolescents from tobacco and nicotine. Pediatrics. 2023;151(5):e2023061804.
149. Smokefree.gov. Speak to an expert. https://smokefree.gov/tools-tips/get-extra-help/speak-to-an-expert. Accessed July 12, 2024.
150. Smokefree.gov. Become a smoke-free teen. https://teen.smokefree.gov/. Accessed July 13, 2024.
151. American Academy of Pediatrics. Tobacco Control and Prevention. Nicotine replacement therapy and adolescent patients. https://www.aap.org/en/patient-care/tobacco-control-and-prevention/youth-tobacco-cessation/nicotine-replacement-therapy-and-adolescent-patients/. Accessed July 13, 2024.
152. FDA. FDA in brief: FDA updates label for Chantix with data underscoring it’s not effective in children 16 and younger. February 22, 2019. https://www.fda.gov/news-events/fda-brief/fda-brief-fda-updates-label-chantix-data-underscoring-its-not-effective-children-16-and-younger. Accessed July 13, 2024.
153. Bupropion hydrochloride (SR)- bupropion hydrochloride tablet, extended release. A-S Medication Solutions; Dr. Reddy’s Laboratories; Princeton, NJ: December 2023. https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=994229b0-e190-49e3-83ce-6a2063f7335a&type=pdf. Accessed July 13, 2024.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

To comment on this article, contact rdavidson@uspharmacist.com.