Research Watch: Nicotine Patches and Teens

Diana Zuckerman
March 1, 2000

Richard Hurt, M.D., and colleagues

Archives of Pediatric and Adolescent Medicine

Vol. 154, January 2000

Available free online at or from

Dr. Hurt, 200 First St SW, Rochester, MN 55905. E-mail:

Smoking is increasing among teens, and the expectation is that teens will get more and more addicted to nicotine the longer they smoke. Nicotine patches have been found to be effective for helping adults stop smoking, but unfortunately a recent study found that they are not nearly as effective in helping teens to quit. They can, however, help teens dramatically cut back on cigarettes.

Dr. Richard Hurt and his colleagues at the Mayo Clinic were easily able to recruit 101 Minnesota teenagers who said they wanted to quit. Almost all the teens were white, most were 16 or 17, and 59 percent were boys. Although 96 of the youths were still smoking six months after treatment with the nicotine patch, they were averaging less than three cigarettes a day, compared to 18 a day before treatment.

Approximately one in four adults who use nicotine patches are able to quit, so these findings were surprisingly low, according to Hurt, director of Mayo Clinic’s Nicotine Dependence Center. He points out that studies show that between 0-11 percent of teens stop smoking on their own, without any kind of treatment. That would suggest that the nicotine patches were no more effective than no treatment at all.

The patch treatment lasted six weeks, requiring daily diaries and weekly visits to the clinic. The diaries were surprisingly accurate, perhaps because the teens knew the researchers would compare the diaries to test results based on the amount of carbon monoxide in the teenagers’ breath. Ten of the teens never came back after their first visit. Each of the 71 who finished the entire six weeks received $100 for participating. Of the 42 days they were supposed to wear patches, the teens wore patches an average of 38 days — surprisingly compliant for teenagers. At the end of the six weeks, 11 had stopped smoking, but six months later, only 5 were still abstinent.

Almost two-thirds of the teens reported that there were other smokers in their households. When asked what other household members did to help or hurt their efforts to stop smoking, family members who smoked nearby or kept cigarettes in the house were major complaints. Nagging, not surprisingly, was also seen as harmful. Praise, encouragement and talking about the program were seen as helpful. Although these questions focused on family members, the results are obviously relevant to other adults and places where the teens spend time.

Hurt focused on whether there are biological differences that could account for the failure. For example, he found more nicotine withdrawal symptoms than expected, suggesting that the patch wasn’t providing enough nicotine to many of the teens. Hurt was not very encouraged by the drastic reduction in the number of cigarettes smoked, since research on adults has suggested that if smoking doesn’t stop completely, the habit is likely to continue. However, he points out that reducing the habit could make teens more likely to quit if they subsequently enroll in behavior-oriented smoking cessation programs.

Zuckerman, Diana. "Nicotine Patches and Teens." Research Watch review of "Nicotine Patch Therapy in 101 Adolescent Smokers." Youth Today, March 2000, p. 23.

©2000 Youth Today. Reprinted with permission from Youth Today. All rights reserved.