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Efficacy of the nicotine patch in adolescents & young adults

Institution: University of California, San Francisco
Investigator(s): Mark Rubinstein, M.D.
Award Cycle: 2002 (Cycle 11) Grant #: 11FT-0233 Award: $69,800
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Postdoctoral Fellowship Awards

Initial Award Abstract
Tobacco use is the single most preventable cause of death in the United States. Tobacco smoking is of particularly concern among adolescents and young adults given the fact that the majority of adult smokers became regular smokers before the age of 20. Even more concerning is the fact that most adolescent smokers have tried to quit but failed. Because the effects of tobacco smoking are additive, intervening among young adult and adolescent smokers early is imperative to help prevent the costly and often devastating effect of tobacco related disease. The role of nicotine replacement as a way of helping smokers wishing to quit has already been proven effective among adult smokers. Despite the enormous problem of tobacco use among the young, only one study has examined the effectiveness of the nicotine replacement patch in adolescents. Unfortunately, this study did not use tobacco cessation counseling as part of the treatment. To the best of our knowledge, no study has utilized both comprehensive counseling and nicotine replacement in adolescents and young adults. The goal of this research is to study the nicotine replacement patch along with weekly counseling among a group of extremely “high-risk,” economically disadvantaged young adults living at a Job Corps facility in Northern California. Following this group of young smokers, we propose to: 1) determine whether or not these extremely high-risk young adults will use the patch, 2) examine their satisfaction with the patch, 3) identify issues around and barriers to compliance with the patch, and 4) determine the efficacy of the nicotine patch in this group of young adults.

The study population will be approximately 100 economically disadvantaged and largely minority, young adults (ages18-24) living at a Job Corps facility in Northern California who smoke at least 10 cigarettes per day and are interested in quitting. Study participants will be recruited during routine visits at an onsite medical clinic and through flyers and posters. Participants will receive 10 weeks of weekly counseling along with step-wise nicotine replacement. Follow-up will occur at 12, 24 and 52 weeks and will include data on smoking status, which will be confirmed by salivary cotinine levels.

In addition to providing information on treating tobacco dependence in this high-risk group of difficult to treat adolescents and young adults, we hope to provide a framework for the development of similar tobacco cessation programs at other residential facilities.

Adolescents perceptions of when smokers get disease.
Periodical: Pediatric Research Index Medicus:
Authors: Rubinstein ML, Halpern-Felsher BL ABS
Yr: 2002 Vol: 51 Nbr: 8A Abs: Pg:

Perceived risks and benefits of smoking: differences between adolescents who have and have not smoked.
Periodical: Journal of Adolescent Health Index Medicus:
Authors: Halpbern-Felsher BL, Biehl M, Rubinstein ML ABS
Yr: 2003 Vol: 32 Nbr: 2 Abs: Pg: 147-148