Does Self-Rated Addiction and the Heaviness of Smoking Index Predict Nicotine Replacement Therapy Product Use in Adolescent Smokers?

Nicotine dependence among adolescents in the European Union: How many and who are affected?

Background

Nicotine dependence during adolescence increases the risk of continuing smoking into adulthood. The magnitude of nicotine dependence among adolescents in the European Union (EU) has not been established. We aimed to estimate the number of nicotine dependent 15-year-old adolescents in the EU, and identify high-risk groups.

Methods

The number of nicotine dependent 15-year-olds in the EU was derived combining: (i) total number of 15-year-olds in the EU (2013 Eurostat), (ii) smoking prevalence among 15-year-olds (2013/2014 HBSC survey) and (iii) proportion of nicotine dependent 15-year-olds in six EU countries (2013 SILNE survey). Logistic regression analyses identified high-risk groups in the SILNE dataset.

Results

We estimated 172 636 15-year-olds were moderately to highly nicotine dependent (3.2% of all 15 years old; 35.3% of daily smokers). In the total population, risk of nicotine dependence was higher in males, adolescents with poor academic achievement, and those with smoking parents or friends. Among daily smokers, only lower academic achievement and younger age of smoking onset were associated with nicotine dependence.

Conclusion

According to our conservative estimates, more than 172 000 15-year-old EU adolescents were nicotine dependent in 2013. Prevention of smoking initiation, especially among adolescents with poor academic performance, is necessary to prevent a similar number of adolescents getting addicted to nicotine each consecutive year.

Applying a Social–Ecological Framework to Factors Related to Nicotine Replacement Therapy for Adolescent Smoking Cessation

Objective:

This systematic review synthesizes factors related to nicotine replacement therapy (NRT) use among adolescents seeking to quit smoking, using the social–ecological model as a guiding framework.

Data Source:

Searches of PubMED, ProQuest, EBSCOhost, and ERIC were conducted in July 2016.

Study Inclusion and Exclusion Criteria:

Original studies of cigarette smokers younger than 18 years that discussed NRT were included.

Data Extraction:

Two reviewers individually extracted study purpose, sample, design, and results.

Data Synthesis:

Factors were categorized by social–ecological model level and summarized.

Results:

A total of 103 907 articles were identified during initial search. After narrowing to peer-reviewed articles in English and eliminating reviews and adult-only studies, we reviewed 51 articles. These 51 articles identified factors from studies at each level of the social–ecological model: intrapersonal ( k = 20), interpersonal ( k = 2), organizational ( k = 7), community ( k = 11), and public policy ( k = 14).

Conclusion:

Findings provide insight into the applicability of NRT for adolescent smoking cessation, and factors by social–ecological model level highlight areas for additional research. Future adolescent NRT studies should assess factors at the interpersonal, organizational, and community levels, as well as the interactions between levels.