Smoking Cessation for Adolescents: A Review of Pharmacological and Psychosocial Treatments

Abstract

Unlike the vast literature on smoking cessation in adults, research in adolescents has gained significant attention only within the last decade. Even with this increase in focus, research into pharmacological aids for smoking cessation in adolescents (e.g., nicotine replacement therapy, bupropion) is a more recent phenomenon and has produced only modest results. While more extensive, much of the research on behaviorally-or psychosocially-based adolescent smoking cessation interventions has been limited by a lack of control for contact time, biochemical verification of self-reported abstinence, and/or a theoretical focus for the interventions. The MEDLINE, PubMed, PSYCInfo CINHAL and Cochrane Systematic Review databases were searched for articles relevant to adolescent smoking cessation treatment. After briefly examining the adolescent smoking cessation research prior to 2000, more recent developments in pharmacological aids and psychological treatment will be reviewed. Investigations have made progress in elucidating efficacious treatments for adolescent smokers, but much work remains to be done in both pharmacological and non-pharmacological areas of treatment. With the current state of the literature as a guide, future directions for research into smoking cessation for adolescents will be proposed.

Contribution of Hypothalamic–Pituitary–Adrenal Activity and Environmental Stress to Vulnerability for Smoking in Adolescents

“…Adolescent smokers frequently report stress reduction as a motive for smoking (Dozois et al, 1995; Nichter et al, 1997). The data from this study suggest that such persons might benefit from adjunctive psychosocial interventions, such as assertiveness training and cognitive-behavior therapy, aimed to reduce and/or cope with stressful experiences (Schepis and Rao, 2008). Future studies should evaluate the efficacy of pharmacotherapy and various psychosocial interventions, singly and in combination, in smokers stratified on levels of stress.…”

“…Anti-glucocorticoid agents and CRH antagonists might have anti-depressant properties, and have been tested in humans for the treatment of depression and other psychiatric disorders (Gallagher et al, 2008; Holsboer and Ising, 2008; Seymour et al, 2003). Moreover, bupropion and other antidepressant drugs are effective in reducing smoking in addition to alleviating depressive symptoms (Hajek et al, 2009; Schepis and Rao, 2008; Tonstad, 2002). Data from both clinical and preclinical studies suggest that treatment with most antidepressant agents reduces responsiveness to stress (Duman et al, 1999; Holsboer, 2001).…”

Cigarette Smoking and Onset of Mood and Anxiety Disorders

“…The observed association with state cigarette taxes highlights the role of policy initiatives and financial disincentives in discouraging smoking behavior. Public health interventions involving education and financial disincentives may be combined with individual-level smoking cessation interventions for youths 63–66 to effectively reduce smoking behavior among this vulnerable population group.…”

Anti-smoking initiatives and current smoking among 19,643 adolescents in South Asia: findings from the Global Youth Tobacco Survey

“…Evidence suggests that the cigarette smoking habit usually begins before the attainment of adulthood [1], and adolescents, in particular, are more prone to develop nicotine dependence [2]. This finding is of immense concern for countries like Pakistan, India, Bangladesh, and Nepal, where cigarette smoking is highly prevalent among adolescents [3-5] and 26%–29% of national populations are comprised of individuals aged 14 years or younger [6].…”