Developing treatment for tobacco addicted youth - Issues and challenges

It is now clear that adolescence is not only the primary time during which cigarette smoking is initiated; it is also the time during which the transition from experimentation to some level of dependence occurs. As discussed in this review, by age 18 approximately two-thirds of cigarette smokers regret having started smoking, one-half have already made a quit attempt, and nearly 40% have some interest in obtaining treatment for their dependence. Unfortunately, treatment in young people has not kept pace with the emerging need for treatment and many fundamental issues require study; in fact it is not clear the degree to which adult-validated treatments, such as nicotine replacement therapies, will be of comparable levels of benefit and risk in young people. The issues that require research include (1) a thorough consideration of adolescent nicotine dependence and potential pharmacologic adjuncts, (2) a consideration of social, health, risk perception, and intrapersonal factors that may facilitate or inhibit cessation attempts of maintenance among youth, and (3) advanced youth cessation trials research designs and measurement. We conclude that although the research challenges are many and diverse, all are surmountable by concerted efforts, and the opportunity to reduce the current projections of premature tobacco-caused mortality in one-third to one-half of cigarette smoking youth strongly argue for such efforts.