The leading causes of adolescent mortality in the United States are accidents, homicide, & suicide. Additional mortality is related to substance abuse, risky sexual behaviours, poor nutrition, & inadequate physical activity. The author recommends physicians target these risk factors with preventive counselling, noting adolescents may be reluctant to initiate such discussions because of concerns related to confidentiality. The key to providing relevant & useful preventive counselling is developing trust. (31 refs.)