Smoking cessation in adolescents: nicotine patches seem to be effective

The combination of the use of nicotine patches and monitoring of cognitive-behavioral therapy proves effective for the treatment of tobacco dependence adolescents indicate the results of a published on the website of the journal American study "Pediatrics".

After peaking in the late 90s, youth smoking appears to be declining in recent years, say the members of the research team from the Research Department of the tobacco National Institute on Drug Abuse. The available data suggest that a significant proportion of young smokers has already tried unsuccessfully to quit smoking, usually by cold turkey, are they. Because teens can become addicted to tobacco for a lower consumption than adults, they are often subject to withdrawal symptoms when such attempts, say the authors. For this reason, the need for safe and effective nicotine replacement therapy in this population remains valid.

A total of 120 adolescents aged 13-17 years participated in their study. All smoked more than ten cigarettes per day (average daily consumption: 18.8 cigarettes) were addicted to nicotine and motivated to quit smoking (greater than or equal to five testing of tobacco dependence Fagerström score).

Participants were divided into three groups according to the NRT, which assays have been adapted to their tobacco consumption-which were offered to them for three months, in addition to cognitive-behavioral therapy. Thus, without which neither they nor the researchers know what the alternatives offered to each person, some received active patch and placebo gum, others were prescribed a placebo patch and active gum, while treatment past participants combined a placebo patch and placebo gum. The last follow-up visit took place six months after the start of weaning, three months after the end of treatment.

The analysis of the evolution of the rate of carbon monoxide (CO) in exhaled air, which reflects the consumption of tobacco in the previous twelve hours, confirmed prolonged abstinence (at least two weeks) in 17 7% of participants who received the active patch, against only 6.5% of those who used chewing gum and 2.5% of those who received only placebo treatment.

Moreover, a decrease of more than 80% of the number of cigarettes smoked each day qualified as "encouraging" by the authors, was observed in all three groups at the end of the treatment phase results without n 'shows significant differences depending on the treatment followed.

Nevertheless, the biomarkers of exposure to cigarette smoke (CO levels in exhaled air and saliva thiocyanate concentration) were not significantly changed from the time of initiation of treatment, the authors note . According to them, the most likely explanation for this observation through the "compensation phenomenon", which is to inhale the smoke more deeply to extract a comparable amount of nicotine in spite of reducing the number of cigarettes smoked each day.

Both forms of nicotine replacement therapy appear to have been well tolerated, with results comparable to those reported in clinical trials in adults side effects.

However, adherence (rigor with which participants completed treatment, as reflected by the daily use of substitutes available) appeared more important for the patch (on average 78.4% in the "patch", 82 8% in the group "gum" and 80.9% in the "placebo") for chewing gum (with a respective average of 42.1%, 38.5% and 50.7% for the three groups).

For U.S. researchers, the unpleasant taste of the gums, though not listed among the side effects, may have influenced adherence. They suggest that future studies evaluating the effectiveness of chewing gum use scented products with mint now available on the market and provide more detailed information prior to initiation of treatment explanations.

Without a definitive answer to the question of the effectiveness of patches and gum, these results are in line with recommendations to expand the use of patches, in addition to cognitive behavioral therapy in adolescents candidates smoking cessation, the authors conclude. Especially the fact that three quarters of the participants in this study had a diagnosed psychiatric disorder probably affected the success rate of weaning, they note.

Nicotine replacement therapy can be used from the age of 15, and have an interest in smoking cessation for dependents.