Nicotine replacement therapy use among adolescent smokers seeking cessation treatment

Abstract

Objective: To examine the correlates of prior nicotine replacement therapy (NRT) in an urban sample of adolescent smokers seeking smoking cessation treatment.

Design: Adolescents were recruited via radio, TV and print advertisements for participation in treatment studies. Participants completed a structured interview usinga prescreeningquestionnaire.

Setting: Data were collected via a telephone interview by trained research personnel.

Participants: A sample (N=1879) cessation treatment-seeking volunteer boys (38.2%) and girls (61.8%) aged 12 to 17 years, from a diverse ethnic background residing in the Baltimore, Maryland metropolitan area.

Interventions: No interventions were used in this observational study.

Main outcome measures: Use of NRT in adolescents stratified by age, Fagerstrom Test of Nicotine Dependence (FTND), and race/ethnicity.

Results: The sample had a mean FTND score of 5.7 (SD = 2.2). About 41% smoked 11 to 20 cigarettes per day. Adolescent smokers who had used NRT were statistically but only marginally older than those who had not (15.9 vs 15.7 years; t-test= -2.60, P=0.01). FTND score, a measure of nicotine dependence, was higher among those who had used NRT (6.0 vs 5.6; t-test= -3.37, P= .001). African American adolescents were less likely to have used NRT than their European American counterparts (33.0% vs 61.2%; chi2=16.09, P<.003). After stepwise logistic regression analyses, age, FTND and race/ethnicity remained predictors of NRT use.

Conclusion: Our results show differences in NRT use patterns based on age, FTND, and race/ethnicity. European American youths are more likely than their 'other' counterparts to use NRT, after adjusting for age and smoking severity, whereas, African American youth are less likely than their 'other' counterparts to use NRT. These findings suggest racial/ethnic disparities in accessing smoking cessation modalities among adolescents. Further research is needed to fully elucidate factors contributing to these differences in order to facilitate increased smoking cessation rates among all adolescents.