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The Informed Parent

Teen Smokers

by Peter W. Welty, M.D., F.A.A.P.
Published on Nov. 28, 2005

Parents often ask how to manage their teenager who is smoking cigarettes. Often the teen begins to smoke when the adults in the home smoke, too. Even with the recent reduction in the rate of cigarette smoking among adolescents, it remains a major public health problem. Almost 16 percent of the 12th graders in the United States smoke daily. Most smokers begin the habit before age 18, and approximately 3000 adolescents start smoking every day in the United States.

Cigarette smoking in teenagers affects lung function and bone growth, and may cause increasing risk of depressive disorder. Cigarette smoking during pregnancy can cause low birth weight, hyperactivity, conduct disorder or increased nicotine receptors in the children. Environmental tobacco exposure before age 10 may increase the risk of leukemia and lymphoma in adulthood. Also, cigarette smoking before age 13 is strongly associated with psychiatric illness later on in adolescents.

Sometimes doctors use pharmacological treatments such as the nicotine patch, gum, inhalers or lozenges, and Wellbutrin to help the teen stop smoking. Of course, the teen needs to want to quit before any of these measures can be employed. To date, nicotine replacement therapy (the patch, gum, inhaler or lozenge) and Wellbutrin (buproprion) have been the treatments most explored in teenage smokers. Some studies have shown that the transdermal nicotine patch demonstrated the highest abstinence rate, at 17.6 percent in a group of teens, versus 6.5 percent for the gum and 2.5 percent for the placebo or sugar pill. Other studies have shown the promise of Wellbutrin for abstinence from cigarettes, at a rate of 31.25 percent.

A combination approach of behavioral therapy, along with Wellbutrin or a nicotine patch, may be best for your teen. Speak with your doctor about which treatment approach is best. Nicotine dependence, especially in the teenage years, is an under reported but serious public health problem today.

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