NIDA's Intramural Research Program (IRP) recently opened a new Teen Tobacco Addiction Treatment Research Clinic at the Bayview Medical Center in Baltimore. At the clinic, researchers will evaluate promising therapies for adolescent nicotine addiction.
One of the clinic's first research projects will be a pilot study of smoking cessation treatments for 13- to 17-year-old cigarette smokers. "More than one-third of 17-year-olds who smoke say they are interested in some form of treatment to help them quit," says IRP's Dr. Eric Moolchan, director of the new clinic and leader of the smoking cessation study.
The research project will test the combination of nicotine replacement therapy (NRT) and group counseling for treating nicotine addiction in adolescents. NRT helps smokers learn to abstain from smoking by replacing the nicotine that they previously obtained from cigarettes, thereby preventing withdrawal symptoms and craving for nicotine. NRT forms currently available include the nicotine patch and gum.
Dr. Moolchan says that many health care providers are reluctant to prescribe nicotine patches or gum for adolescents because of a lack of studies showing that these products are safe and effective in this age group. The IRP pilot study will help determine whether adolescents can use the nicotine patch and gum safely, whether they can tolerate the same nicotine doses in the patch and gum as adults, and whether they will follow the instructions on how to use these products. Later studies will focus more on the effectiveness of the patch and gum in helping adolescents quit smoking.
Cutting the ribbon to dedicate NIDA's new Teen Tobacco Addiction Treatment Research Clinic (TTATRC) in Baltimore. From left, Dr. Jean Lud Cadet, clinical director, NIDA's Intramural Research Program (IRP); NIDA Director Dr. Alan I. Leshner; Dr. Barry Hoffer, director of NIDA's IRP; Dr. Eric Moolchan, director of TTATRC; and Dr. Monique Ernst, IRP researcher."It's important that we develop effective treatments for young people to try to get them to quit smoking as early as possible," says IRP Director Dr. Barry Hoffer. "Research shows that 90 percent of people who die prematurely of a cigarette-related disease started smoking when they were adolescents. If we can help adolescents quit smoking, we should be able to prevent many of these premature deaths."
The IRP study will have 3 groups, each with 18 adolescents. The first group will receive active patches containing nicotine and placebo gum without nicotine, the second group will receive placebo patches and active gum, and the third group will receive placebo patches and placebo gum. Participants will not be told whether the products they receive are active or placebo.
All three groups will also participate in group counseling sessions because studies with adult smokers have indicated that smoking cessation programs that combine behavioral therapy with medications produce the highest abstinence rates. In the counseling sessions, a mental health professional and Dr. Moolchan, who is a pediatrician, will discuss various topics involving smoking and health and will teach the adolescents how to modify their behavior to deal with situations that might cause them to smoke.
Even though smoking is the primary focus of the sessions, other topics-such as peer relations, school, and dating-will be discussed. "Addressing these other issues is important because adolescent smokers often think that smoking helps them in their social relations," says Dr. Moolchan. "Furthermore, problems concerning social relations can negatively affect mood, and smokers often regulate their mood with nicotine."
The IRP project also will examine other aspects of adolescent smoking. One study will analyze how adolescents smoke cigarettes-for example, how deeply they inhale or how many puffs they take per cigarette. IRP researchers will also study whether nicotine withdrawal causes adolescents to experience problems with concentration and short-term memory and whether nicotine-replacement treatments can reverse these deficits. Another project will measure chemical evidence of cigarette consumption in saliva to determine whether adolescents metabolize the components of cigarette smoke in the same way that adults do.
The researchers will recruit adolescents from the Baltimore area through referrals from healthcare providers, schools, churches, and youth centers. Dr. Moolchan hopes that this study will establish contacts in the community that can be used to recruit adolescents for future studies.