Treatment of adolescent smokers with the nicotine patch.
ABSTRACT This study examined the effects of the nicotine patch on craving and withdrawal symptoms, safety, and compliance among adolescents. The secondary goal was to conduct a preliminary investigation of the effectiveness of the nicotine patch in helping adolescents quit smoking. The study design was a double-blind, placebo-controlled, randomized trial of the nicotine patch. The intervention also provided intensive cognitive-behavioral therapy and a contingency-management procedure. Participants (n=100) attended 10 treatment visits over 13 weeks. Compared with the placebo patch group, the active nicotine patch group experienced a significantly lower craving score and overall withdrawal symptom score (p=.011 and p=.025, respectively), as well as a time trend toward lower scores (p<.001) in craving only. Moreover, the nicotine patch appeared safe for adolescents to use. No differences by treatment group were found in experiencing adverse events, except that the participants in the placebo patch group reported more headaches than those in the active nicotine patch group. As another measure of safety, the overall mean salivary cotinine levels were significantly lower at 1, 6, 8, and 10 weeks postquit (all p<.05) compared with baseline levels, although these results were confounded by dropouts. Additionally, a significant number of participants were compliant with using the nicotine patch daily. Finally, point prevalence (7-day and 30-day abstinence rates) and survival analysis of participant abstinence indicated no significant differences between treatment groups. The results of this study suggest that the nicotine patch is a promising medication and a larger clinical trial of the nicotine patch among adolescents is warranted.
- SourceAvailable from: Stefan Mihaicuta2010 edited by ANTIGONA TROFOR, 01/2010; Editura Tehnopress Iasi., ISBN: 978-973-702-768-9
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ABSTRACT: With the emerging role of pharmacists in implementing smoking cessation services and the recent evidence about smoking cessation pharmacotherapies, a needs analysis to assess baseline knowledge about current smoking cessation practice is needed; hence, training and development in this area can target possible 'gaps'. This study aimed at exploring pharmacy students' knowledge about and attitudes toward smoking cessation, as compared to practicing community pharmacists and smoking cessation educators. The overall objective was to uncover underlying 'gaps' in pharmacy-based smoking cessation practice, particularly clinical gaps. Final-year pharmacy students at the University of Sydney, practicing community pharmacists and smoking cessation educators in Australia. As no previous standard pharmacist-focused smoking cessation knowledge questionnaires exist, a review of the literature informed the development of such a questionnaire. The questionnaire was administered to a cohort of fourth-year pharmacy students at the University of Sydney, practicing pharmacists and smoking cessation educators. Data analysis was performed using Predictive Analytics SoftWare (PASW® Statistics 18). Mean total scores, independent t-tests, analysis of variances and exploratory factor analysis were performed. To determine areas of major clinical deficits about current evidence related to smoking cessation interventions at the pharmacy level. Responses from 250 students, 51 pharmacists and 20 educators were obtained. Smoking educators scored significantly higher than pharmacists and students (P < .05), while score differences in the latter two groups were not statistically significant (P > .05). All groups scored high on 'general' knowledge questions as compared to specialised pharmacologic and pharmacotherapeutic questions. All respondents demonstrated positive attitudes toward the implications of smoking cessation. Factor analysis of the 24-item knowledge section extracted 12 items loading on 5 factors accounting for 53% of the total variance. The results provide a valid indication of 'gaps' in the practice of up-to-date smoking cessation services among Australian pharmacy professionals, particularly in clinical expertise areas involving assessment of nicotine dependence and indications, dosages, adverse effects, contraindications, drug interactions and combinations of available pharmacotherapies. These gaps should be addressed, and the results should inform the design, implementation and evaluation of a pharmacy-based educational training program targeting current clinical issues in smoking cessation.SpringerPlus 01/2013; 2:449.
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ABSTRACT: Previous research has shown limited efficacy of nicotine replacement therapy (NRT) among adolescents and generally low compliance rates. As higher compliance rates are associated with improved abstinence rates, the present study examined predictors of NRT compliance. This study aims to test whether different NRT compliance trajectories can be distinguished among adolescents, to test whether these trajectories can be predicted by demographic, smoking-related, and personality factors, and to examine abstinence rates for each trajectory. Data were used from a randomized controlled trial that tested the efficacy of nicotine patches versus placebo patches among 265 Dutch adolescents. During NRT treatment, adolescents filled out six online questionnaires in which they reported on the number of days they used the patches. Predictors (i.e., demographic and smoking-related factors and personality characteristics) and end-of-treatment abstinence were also administered through these self-reports. Latent class growth analysis (LCGA) was used to analyze compliance data by classifying individuals into similar growth trajectories. Three compliance trajectories were found (i.e., "compliers" (n = 89), "moderate decreasers" (n = 41), and "strong decreasers" (n = 127)). The compliers can be characterized by higher levels of conscientiousness and agreeableness and lower levels of extraversion compared with the strong decreasers, and by higher levels of conscientiousness and education compared with the moderate decreasers. Among the compliers, a substantially higher percentage of adolescents achieved abstinence at end-of-treatment (10 %) compared with the moderate decreasers (3 %) and the strong decreasers (6 %). These findings could be the starting point for person-tailored interventions that aim to enhance NRT compliance rates among adolescents.Psychopharmacology 03/2014; · 3.99 Impact Factor