Nicotine patch therapy in adolescent smokers

There do not seem to be any harmful side effects of nicotine patches for teenage smokers. Twenty-two teenage smokers who smoked more than 20 cigarettes per day and were trying to quit smoking wore nicotine patches for 8 weeks. During this time period they also participated in a support group and received individual counseling. The participants reported only minor side effects including skin reactions, vomiting, headaches, and dizziness. Three participants had quit smoking at the end of the 8-week period and one was not smoking 6 months after the study period.
ABSTRACT. Objective. To evaluate the safety, tolerance, and efficacy of 24-hour nicotine patch therapy in adolescent smokers who were trying to stop smoking. Design. Nonrandomized, open-label, 6-month clinical trial. Setting. Five public high schools in the Rochester, MN, area. Subjects. Twenty-two adolescent smokers, aged 13 through 17 years, with current smoking rate of 20 or more cigarettes per day (cpd). Intervention. Daily nicotine patch therapy for 8 weeks (22 mg/d for 6 weeks followed by 11 mg/d for 2 weeks). Weekly individual behavioral counseling and group support continued for 8 weeks with follow up visits at 3 and 6 months and a mailed survey at 1 year. Main Outcome Measures. Self-reported smoking abstinence verified by expired air carbon monoxide of 8 ppm or less, nicotine withdrawal symptoms, adverse experiences, and blood cotinine levels. Results. Subjects had a mean [+ or -] SD smoking rate of 23.3 [+ or -] 5.0 (range, 20 to 35) cpd at study entry and 2.6 [+ or -] 1.6 years of smoking the mean age was 15.9 [+ or -] 1.2 (range 13 through 17) years, and 68% were girls. Of the 22 participants, 19 (86%) completed patch therapy, 3 (14%) had biochemically validated smoking cessation at week 8, and 1 continued to be smoke free at 3 and 6 months after patch initiation. There was a significant decrease from baseline in the mean nicotine withdrawal scores for days 4 and 7 of week 1 and the mean for weeks 2 through 8. Skin reactions were the most common adverse event. As the worst skin reactions, 55% had erythema only, 5% had erythema and edema, and 9% had erythema and vesicles, whereas 32% had no skin reactions. Other reported adverse events were headaches (41%), nausea and vomiting (41%), tiredness (41%), dizziness (27%), and arm pain (23%). None of these were considered serious, life threatening, or led to the discontinuation of patch therapy. In adults with comparable smoking rates, we found that the adolescents had lower blood cotinine levels. Those smoking 20 to 25 cpd had cotinine levels of 146 [+ or -] 84 (adolescents) vs 260 [+ or -] 98 (adults) ng/ml, and those smoking 26 to 35 cpd had levels of 169 [+ or -] 73 vs 276 [+ or -] 110 ng/ml, respectively. Conclusion. Nicotine patch therapy seems safe in adolescent smokers. Placebo-controlled trials are needed to establish the efficacy of nicotine patch therapy in adolescents. Pediatrics 1996;98:659-667; nicotine patch therapy, adolescent smokers.
Tobacco use is the single most preventable cause of death in the United States.[1] In 1992 tobacco killed more people in the United States than alcohol, cocaine, crack, heroin, homicide, [...]