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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.

Garrison MM, Christakis DA, Ebel BE, Wiehe SE, Rivara FP. Smoking cessation interventions for adolescents: a systematic review. Am J Prev Med. 2003; 25: 363-367.

Botello-Harbaum M, Schroeder JR, Collins CC, Moolchan ET. Nicotine replacement therapy use among adolescent smokers seeking cessation treatment. Ethn Dis. 2010; 20(2): 180-184.

Gray KM, Carpenter MJ, Baker NL, Hartwell KJ, Lewis AL, Hiott DW, Deas D, Upadhyaya HP. Bupropion SR and contingency management for adolescent smoking cessation. J Subst Abuse Treat. 2011; 40(1): 77-86.

Hanson K, Allen S, Jensen S, Hatsukami D. Treatment of adolescent smokers with the nicotine patch. Nicotine Tob Res. 2003; 5: 515-526.

Hanson K, Zylla E, Allen S, Li Z, Hatsukami DK
. Cigarette reduction: an intervention for adolescent smokers. Drug Alcohol Depend. 2008; 95(1-2): 164-168.

Killen JD, Robinson TN, Ammerman S, Hayward C, Rogers J, Stone C, Samuels D, Levin SK, Green S, Schatzberg AF
. Randomized clinical trial of the efficacy of bupropion combined with nicotine patch in the treatment of adolescent smokers. J Consult Clin Psychol. 2004; 72: 729-735.

Monuteaux MC, Spencer TJ, Faraone SV, Wilson AM, Biederman J. A randomized, placebo-controlled clinical trial of bupropion for the prevention of smoking in children and adolescents with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2007; 68: 1094-1101.

Moolchan ET, Robinson ML, Ernst M, Cadet JL, Pickworth WB, Heishman SJ, Schroeder JR. Safety and efficacy of the nicotine patch and gum for the treatment of adolescent tobacco addiction. Pediatrics. 2005; 115: e407-e414.

Muramoto ML, Leischow SJ, Sherrill D, Matthews E, Strayer LJ. Randomized, double-blind, placebo-controlled trial of 2 dosages of sustained-release bupropion for adolescent smoking cessation. Arch Pediatr Adolesc Med. 2007; 161: 1068-1074.

Roddy E, Romilly N, Challenger A, Lewis S, Britton J. Use of nicotine replacement therapy in socioeconomically deprived young smokers: a community-based pilot randomised controlled trial. Tob Control. 2006; 15: 373-376.

Rubinstein ML, Benowitz NL, Auerback GM, Moscicki AB. A randomized trial of nicotine nasal spray in adolescent smokers. Pediatrics. 2008; 122(3): e595-600.

Upadhyaya HP, Brady KT, Wang W. Bupropion SR in adolescents with comorbid ADHD and nicotine dependence: a pilot study. J Am Acad Child Adolesc Psychiatry. 2004; 43: 199-205.

Colby SM, Gwaltney CJ
. Pharmacotherapy for adolescent smoking cessation. JAMA. 2007; 298: 2182-2184.

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