A critical evaluation of nicotine replacement therapy for teenage smokers

The purpose of this review is to evaluate the appropriateness and feasibility of nicotine replacement therapy (NRT) in teenage smokers. In this paper, available forms of NRT, the theoretical rationale and efficacy of NRT, ethical considerations, and the feasibility of NRT in teenage smokers are addressed. Although there is a need to better understand the addiction process in adolescents, it is clear that teens have several characteristics similar to adult nicotine dependent smokers. These observations form the basis of the rationale for the use of NRT in teenagers. Only one report has examined the efficacy of NRT in teen smokers. This study observed a stop rate of 4.5% at six-months in 22 subjects using the nicotine patch. In addition to the potential benefits of NRT, ethical issues have been raised regarding the appropriate use of NRT in teenage smokers. Ethical considerations of NRT use in adult smokers, which need further study in adolescents, are nicotine absorption, long-term use, potential for side effects, concomitant smoking, use in pregnant smokers, and abuse liability in nonsmokers and light, intermittent smokers. The feasibility of NRT in adolescent smokers is also discussed, including its acceptability, convenience, social approval, cost, and availability. Many teens are nicotine dependent and additional clinical trials are warranted to evaluate whether NRT provides benefit to adolescent smokers. In addition, further research is needed to study adjunctive behavioral interventions tailored to the developmental and psychosocial needs of adolescents.