Nicotine patch therapy in 101 adolescent smokers: Efficacy, withdrawal symptom relief, and carbon monoxide and plasma cotinine levels

Richard D. Hurt, Gary A. Croghan, Scott D. Beede, Troy D. Walter, Ivana T Croghan, Christi Ann Patten

Research output: Contribution to journalArticle

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Abstract

Objectives: To determine the efficacy of nicotine patch therapy in adolescents who want to stop smoking and to assess biochemical markers of smoking and nicotine intake. Design: Nonrandomized, open-label trial using a 15 mg/16 h patch. Setting: Two midwestern cities. Subjects: One hundred one adolescents aged 13 through 17 years smoking at least 10 cigarettes per day (cpd). Intervention: Six weeks of nicotine patch therapy and follow-up visits at 12 weeks and 6 months. Main Outcome Measures: Self-reported smoking abstinence verified by expired-air carbon monoxide (CO) level of no more than 8 ppm, nicotine withdrawal symptoms, and plasma cotinine level. Results: Forty-one participants were female (mean [± SD] age, 16.5 [± 1.1] years). Median baseline smoking rate was 20.0 cpd (range, 10-40 cpd). Biochemically confirmed point prevalence smoking abstinence was 10.9% (11/101) at 6 weeks and 5.0% (5/101) at 6 months. The mean (± SD) plasma cotinine level at baseline was 1510.9 ± 732.7 nmol/L; for nonsmoking subjects at weeks 3 and 6, 607.8 ± 386.2 and 710.0 ± 772.5 nmol/L, respectively. Plasma cotinine levels were correlated with CO levels at baseline (r = 0.27; P = .006), week 3 (r = 0.34; P = .004), and week 6 (r = 0.26; P = .03) and with mean cigarettes smoked per day during weeks 3 (r = 0.24; P = .04) and 6 (r = 0.30; P = .02). Mean smoking rates decreased significantly during the study, an effect that lessened at 12 weeks and 6 months. Conclusions: Nicotine patch therapy plus minimal behavioral intervention does not appear to be effective for treatment of adolescent smokers. Plasma cotinine and CO levels appear to be valid measures of smoking rates during the cessation process, but not at baseline. Smoking rates were reduced throughout the study. Additional pharmacological and behavioral treatments should be considered in adolescent smokers.

Original languageEnglish (US)
Pages (from-to)31-37
Number of pages7
JournalArchives of Pediatrics and Adolescent Medicine
Volume154
Issue number1
StatePublished - Jan 2000

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Tobacco Use Cessation Products
Cotinine
Substance Withdrawal Syndrome
Carbon Monoxide
Smoking
Tobacco Products
Therapeutics
Nicotine
Biomarkers
Air
Outcome Assessment (Health Care)
Pharmacology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Nicotine patch therapy in 101 adolescent smokers : Efficacy, withdrawal symptom relief, and carbon monoxide and plasma cotinine levels. / Hurt, Richard D.; Croghan, Gary A.; Beede, Scott D.; Walter, Troy D.; Croghan, Ivana T; Patten, Christi Ann.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 154, No. 1, 01.2000, p. 31-37.

Research output: Contribution to journalArticle

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title = "Nicotine patch therapy in 101 adolescent smokers: Efficacy, withdrawal symptom relief, and carbon monoxide and plasma cotinine levels",
abstract = "Objectives: To determine the efficacy of nicotine patch therapy in adolescents who want to stop smoking and to assess biochemical markers of smoking and nicotine intake. Design: Nonrandomized, open-label trial using a 15 mg/16 h patch. Setting: Two midwestern cities. Subjects: One hundred one adolescents aged 13 through 17 years smoking at least 10 cigarettes per day (cpd). Intervention: Six weeks of nicotine patch therapy and follow-up visits at 12 weeks and 6 months. Main Outcome Measures: Self-reported smoking abstinence verified by expired-air carbon monoxide (CO) level of no more than 8 ppm, nicotine withdrawal symptoms, and plasma cotinine level. Results: Forty-one participants were female (mean [± SD] age, 16.5 [± 1.1] years). Median baseline smoking rate was 20.0 cpd (range, 10-40 cpd). Biochemically confirmed point prevalence smoking abstinence was 10.9{\%} (11/101) at 6 weeks and 5.0{\%} (5/101) at 6 months. The mean (± SD) plasma cotinine level at baseline was 1510.9 ± 732.7 nmol/L; for nonsmoking subjects at weeks 3 and 6, 607.8 ± 386.2 and 710.0 ± 772.5 nmol/L, respectively. Plasma cotinine levels were correlated with CO levels at baseline (r = 0.27; P = .006), week 3 (r = 0.34; P = .004), and week 6 (r = 0.26; P = .03) and with mean cigarettes smoked per day during weeks 3 (r = 0.24; P = .04) and 6 (r = 0.30; P = .02). Mean smoking rates decreased significantly during the study, an effect that lessened at 12 weeks and 6 months. Conclusions: Nicotine patch therapy plus minimal behavioral intervention does not appear to be effective for treatment of adolescent smokers. Plasma cotinine and CO levels appear to be valid measures of smoking rates during the cessation process, but not at baseline. Smoking rates were reduced throughout the study. Additional pharmacological and behavioral treatments should be considered in adolescent smokers.",
author = "Hurt, {Richard D.} and Croghan, {Gary A.} and Beede, {Scott D.} and Walter, {Troy D.} and Croghan, {Ivana T} and Patten, {Christi Ann}",
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T2 - Efficacy, withdrawal symptom relief, and carbon monoxide and plasma cotinine levels

AU - Hurt, Richard D.

AU - Croghan, Gary A.

AU - Beede, Scott D.

AU - Walter, Troy D.

AU - Croghan, Ivana T

AU - Patten, Christi Ann

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N2 - Objectives: To determine the efficacy of nicotine patch therapy in adolescents who want to stop smoking and to assess biochemical markers of smoking and nicotine intake. Design: Nonrandomized, open-label trial using a 15 mg/16 h patch. Setting: Two midwestern cities. Subjects: One hundred one adolescents aged 13 through 17 years smoking at least 10 cigarettes per day (cpd). Intervention: Six weeks of nicotine patch therapy and follow-up visits at 12 weeks and 6 months. Main Outcome Measures: Self-reported smoking abstinence verified by expired-air carbon monoxide (CO) level of no more than 8 ppm, nicotine withdrawal symptoms, and plasma cotinine level. Results: Forty-one participants were female (mean [± SD] age, 16.5 [± 1.1] years). Median baseline smoking rate was 20.0 cpd (range, 10-40 cpd). Biochemically confirmed point prevalence smoking abstinence was 10.9% (11/101) at 6 weeks and 5.0% (5/101) at 6 months. The mean (± SD) plasma cotinine level at baseline was 1510.9 ± 732.7 nmol/L; for nonsmoking subjects at weeks 3 and 6, 607.8 ± 386.2 and 710.0 ± 772.5 nmol/L, respectively. Plasma cotinine levels were correlated with CO levels at baseline (r = 0.27; P = .006), week 3 (r = 0.34; P = .004), and week 6 (r = 0.26; P = .03) and with mean cigarettes smoked per day during weeks 3 (r = 0.24; P = .04) and 6 (r = 0.30; P = .02). Mean smoking rates decreased significantly during the study, an effect that lessened at 12 weeks and 6 months. Conclusions: Nicotine patch therapy plus minimal behavioral intervention does not appear to be effective for treatment of adolescent smokers. Plasma cotinine and CO levels appear to be valid measures of smoking rates during the cessation process, but not at baseline. Smoking rates were reduced throughout the study. Additional pharmacological and behavioral treatments should be considered in adolescent smokers.

AB - Objectives: To determine the efficacy of nicotine patch therapy in adolescents who want to stop smoking and to assess biochemical markers of smoking and nicotine intake. Design: Nonrandomized, open-label trial using a 15 mg/16 h patch. Setting: Two midwestern cities. Subjects: One hundred one adolescents aged 13 through 17 years smoking at least 10 cigarettes per day (cpd). Intervention: Six weeks of nicotine patch therapy and follow-up visits at 12 weeks and 6 months. Main Outcome Measures: Self-reported smoking abstinence verified by expired-air carbon monoxide (CO) level of no more than 8 ppm, nicotine withdrawal symptoms, and plasma cotinine level. Results: Forty-one participants were female (mean [± SD] age, 16.5 [± 1.1] years). Median baseline smoking rate was 20.0 cpd (range, 10-40 cpd). Biochemically confirmed point prevalence smoking abstinence was 10.9% (11/101) at 6 weeks and 5.0% (5/101) at 6 months. The mean (± SD) plasma cotinine level at baseline was 1510.9 ± 732.7 nmol/L; for nonsmoking subjects at weeks 3 and 6, 607.8 ± 386.2 and 710.0 ± 772.5 nmol/L, respectively. Plasma cotinine levels were correlated with CO levels at baseline (r = 0.27; P = .006), week 3 (r = 0.34; P = .004), and week 6 (r = 0.26; P = .03) and with mean cigarettes smoked per day during weeks 3 (r = 0.24; P = .04) and 6 (r = 0.30; P = .02). Mean smoking rates decreased significantly during the study, an effect that lessened at 12 weeks and 6 months. Conclusions: Nicotine patch therapy plus minimal behavioral intervention does not appear to be effective for treatment of adolescent smokers. Plasma cotinine and CO levels appear to be valid measures of smoking rates during the cessation process, but not at baseline. Smoking rates were reduced throughout the study. Additional pharmacological and behavioral treatments should be considered in adolescent smokers.

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