A large new review of studies on teen-age smoking finds there is no solid evidence about how to help adolescents kick the habit once they have started. //
Because one-third of smokers take their first cigarette at age 14 and almost 90 percent before age 21, most previous studies of youth tobacco use have concentrated on prevention, not cessation.
“There is not yet sufficient evidence to test the effectiveness of smoking-cessation programs for adolescents, although some approaches show promise,” according to review authors led by Gill Grimshaw at the University of Warwick in Coventry, England.
The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
To make things more complicated, researchers suspect that teenage smokers are anything but mirror images of their adult counterparts. “They may be addicted, but perhaps not as addicted, pharmacologically, (as adults),” said Jonathan Winickoff, M.D., an assistant professor of pediatrics at Harvard Medical School.
Genetic factors also play a role, he said, and researchers may someday gain a greater understanding of them. “In the future, what we might see is more tailoring of approaches, given what the underlying genetic predisposition to addiction is.”
As a result, nicotine-replacement approaches may not work as well in teens, said Winickoff, chair of the American Academy of Pediatrics Tobacco Consortium.
In the Cochrane Library review, a team of researchers searched for studies that examined the effects of smoking-cessation approaches on teens. They found 15 studies, covering 3,605 adolescents that met their criteria.
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