How do you feel about providing traditional treatments for smoking cessation (i.e. nicotine replacement) to teenagers, especially those who aren't old enough to be smoking legally. How do we help this population quit?
I would hesitate to use the nicotine patch, since technically they are not supposed to have that drug until they are 18. But if quitting cold turkey is not working for the teen, there are lots of other options. Wellbutrin is an antidepressant that has been found to be effective as a smoking cessation aid. Also, support groups and other behavioral modification strategies could be used. If all these methods didn't work and the teen really seemed to be dedicated to the idea of quitting, I would say the nicotine patch would be OK.
Wellbutrin actually seems to be rapidly being replaced by Chantix which seems to be a bit more effective than Wellbutrin in smoking cessation.
Taking a look at the website for philip morris, i was pretty surprised to read brutally honest acknowledgments of the various health risks associated with smoking (and even of second hand smoke), all written in very plain language. obviously, education has not been a major issue for quite some time when it comes to combating tobacco use. by now, everybody (especially teenagers) knows that cigarettes are bad for them. the problem is that quitting smoking - like eating healthier, exercising more, drinking less - requires behavioral modification on the part of the patient. naturally, physicians have enjoyed limited success fighting such battles because ultimately, we cannot FORCE patients to change and, contrary to the info-mercials, the cure is never as simple as just taking a pill. believing this to be the case, i think that MOTIVATING our patients is at least as important as EDUCATING them when it comes to behavioral modification. i was hoping we might be able to use this forum to discuss both techniques that we've seen work and also the well-intentioned efforts that tend to backfire.
I looked up about Chantix. I had a patient today who had smoked for 45 years and after talking with her opened up to me and said she was ready to quit, that her daugter had successfully quit and that she was so proud of her she wanted to do the same. She's picking a quit date and will be taking Chantix to help her. I looked it up, here's the literature -- double blind clinical study released in JAMA, the Gonzales study: http://jama.ama-assn.org/cgi/content/abstract/296/1/47
Varenicline was significantly more efficacious than placebo for smoking cessation at all time points and significantly more efficacious than bupropion SR at the end of 12 weeks of drug treatment and at 24 weeks.
Double blind clinical study released in JAMA on the effectiveness of Chantix: http://jama.ama-assn.org/cgi/content/abstract/296/1/47
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Below is a link to some interesting facts about teen smoking from the American Lung Association: http://www.lungusa.org/site/apps/s/content.asp?c=dvLUK9O0E&b=34706&ct=66721