There is little reason to believe that nicotine replacement therapy, bupropion or varenicline pose a significantly greater risk to adolescents who smoke >10 cigarettes per day compared to adults who smoke >10 cigarettes per day.

The U.S. Surgeon General's report "Preventing Tobacco Use in Young People" (Department of Health and Human Services, 1994) and other documents concluded that many adolescents are addicted to nicotine. Thus, some have wondered if medications might be useful to aid smoking cessation in adolescents (Garrison et al., 2003). Several clinical trials of nicotine replacement therapy or bupropion in adolescent have been published (Botello-Harbaum et al., 2010; Gray et al., 2011; Hanson et al., 2003, 2008; Killen et al., 2004; Monuteaux et al., 2007; Moolchan et al., 2005; Muramoto et al., 2007; Roddy et al., 2006; Rubinstein et al., 2008; Upadhyaya et al., 2004). The studies usually report low quit rates, with no significant difference between active and placebo treatments, and low adherence to therapy (Colby & Gwaltney, 2007). However, the studies noted no serious adverse events. Bupropion has been widely used for child psychiatric disorders with very few significant adverse events. There are no published trials of varenicline for smoking cessation in adolescents.

US Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Wasington DC: US Government Printing Office, 1994.

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