Pembroke Pines Demographics According to U.S. Census Bureau (2019) estimates:   * Population (July 2019) –173,591;   * City size – 34.4 square miles spread west and east;   * High school graduate or higher, percent of persons age 25 years+, 2015-2019 – 93.1;   * Median household income (in 2019 dollars), 2015-2019 – $68,745;   * Persons in poverty, percent – 9.3.   * Total health care and social assistance receipts/revenue, 2012 ($1,000) – 952,976. Pembroke Pines is a fairly big city located in Broward County Florida. With its total estimate of population being around 174 thousands, Pembroke Pines is the Florida’s 11th and the U.S.’s 149th largest city. Pembroke Pines Relevant Epidemiological Data According to Cleveland Clinic Florida Weston (2019) assesment:   * 11.7 percent of city’s adult population are smokers;   * 5.7 percent of the population have a chronic obstructive pulmonary disease;   * 12.3 percent of the population have asthma, which is worse than Florida average;   * 7.9 and 2.5 percent of the population are prone to heart disease and heart failure respectively. The Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) of the U.S. reports moderately high rates of smoking associated diseases in adults. Seeing as almost 12 percent of the city’s population over 18 years are smokers, it is not unusual to see high rates of pulmonary and heart diseases among the city’s total population. This could contribute to the topic of tobacco use among adolescents. Problem Description – Tobacco Use among Adolescents   * Persons under 18 years, percent – 20.3 (2019 U.S. Census Bureau);   * Percent of children under age 18 in poverty – 18.3 (Cleveland Clinic Florida Weston 2018);   * Percentage of households with at least 1 of 4 housing problems – 26.0 (Cleveland Clinic Florida Weston 2018). Tobacco use among adolescents occupies one of the leading positions among the modern problems of the younger generation. The starting age of smokers is 7-10 years old, but every year the age limit is decreasing. The majority of smokers are high school students between the ages of 14 and 16. Florida Youth Tobacco Survey Data (2020) reports that “the percent of students who have ever tried cigarettes, cigars, or smokeless tobacco (All Middle and High School Students) was 16.2%” (pp. 3). The rates of children living in poverty or in households with severe housing problems are quite high – the latter being in the bottom quartile among Florida cities. These factors contribute significantly to the problem of adolescent tobacco use in Pembroke Pines. SBIRT Description   * SBIRT refers to Screening, Brief Intervention and Referral to Treatment.   * SBIRT can be used as a tool for detection and subsequent monitoring of adolescent tobacco use. The Screening part of SBIRT is oriented on recognizing and cataloguing the adolescents who use tobacco or are in the risk groups for it, as well as determine appropriate intervention strategy. Subsequently, the stage of Brief Intervention results in a motivational discussion designed specifically for targeting adolescents who use or have a potential of using tobacco. Finally, the Referral to Treatment is the last step, which provides patients with the information about more specialized treatment and specialists. SBIRT Use Example and Outcomes   * SBIRT could be a motivational interviewing skill that nurses can use to engage with college students who use electronic cigarettes (Holden