Tobacco Use Disorder Clinical Trial
Official title:
Treating Tobacco Dependence in Adolescents With Co-occurring Psychiatric Disorders
This research aims to identify efficacious strategies for treating tobacco dependence among
adolescent smokers with co-occurring psychiatric disorders. Adolescent smoking remains a
significant public health issue with 23% of high school students reporting smoking a
cigarette in the past month1. Smoking rates are two to four times higher among adolescents
with psychiatric disorders such as attention deficit disorders, conduct disorder,
depression, anxiety disorders, and alcohol and illicit drug dependencies2-4.
Empirical investigations of adolescent tobacco treatment interventions number less than 50
with many of the studies criticized for methodological problems (i.e., follow up < 6 months,
poor retention, lack of control or comparison groups)2,5, 6. There have been no unequivocal
successes; however, promising interventions include stage-based, cognitive behavioral (CBT),
and multicomponent treatments2, 7. Additionally, the nicotine patch is well tolerated and
safe among adolescents8 and rarely abused9. Less than a third of adolescent tobacco users
report intention to quit in the near future2, 10, 11; thus, it seems critical that cessation
interventions for this complex group be designed to assist smokers at all stages of
readiness through the quitting process. A stepped care approach has the potential of
matching more intensive services to those ready for and in need of greater treatment.
Interventions delivered in health care settings have the appeal of broad reach.
The primary specific aims of this research are to evaluate, in a randomized clinical trial
(N=160), the efficacy of a stepped care intervention for treating smoking among adolescents
recruited from outpatient psychiatry settings. To our knowledge, this would be the first
study to examine outpatient psychiatry settings for treating tobacco dependence in
adolescents. The stepped care intervention combines expert-system contacts, individual CBT
sessions, and 12-weeks of nicotine replacement therapy (NRT).
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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