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Research Efforts: Importance of a Focus on Youth

August 14, 2001: Smoking Cessation: Facing the Challenges of Tobacco Addiction

Cathy L. Backinger, M.P.H., Ph.D., Program Director, Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland

Dr. Backinger described the trends in adolescent smoking and cited the fact that with 3,000 kids becoming regular smokers every day and at least 3.1 million adolescents currently smoking, it is important that we continue to place a heavy emphasis on adolescent tobacco use prevention and cessation efforts. Evidence indicates that two out of three young people wish they had never started smoking but three out of four who have tried to quit at least once have failed. We know that the addiction process is complex, but that young people do become addicted to nicotine and many show signs of dependence before they have become daily smokers. Unfortunately, behavioral interventions to date have reported only modest success and studies of the nicotine patch are not encouraging. On a positive note, recent research is taking into account the developmental aspects of adolescents that distinguish them as more than "little adults" with unique needs for specialized cessation services.

Dr. Backinger briefly described an NCI collaborative effort with NIDA, NICHD, NINR, and NIDCR to "fund innovative research that has clear implications for the immediate and significant reduction of tobacco use by children and youth in the United States." Currently there are 16 NCI-funded behavioral tobacco cessation interventions underway in a variety of settings (clinician, hospital, HMO, school, grocery stores, and homes) with a variety of interventions (self-help materials, video, telephone counseling, and interactive computer-based programs). In addition, there are five currently funded pharmacological interventions for youth tobacco cessation by NIH including two with bupropion, one with bupropion plus the nicotine patch, one with the nicotine patch for smokeless tobacco (which preliminary evidence shows no effectiveness) and one with the nicotine patch and nicotine gum. Dr. Backinger believes that the results of much of this research will help identify new research needs and inform program and policy development.

Concluding her remarks, Dr. Backinger described two efforts underway that will also improve our understanding of youth tobacco cessation. The first is the Youth Tobacco Cessation Collaborative, a public-private partnership, which includes an identification of best practices, an evaluation component and a group at NCI looking at measures. A second effort, Translating Research into Improved Outcomes (TRIO) is also ongoing. TRIO is an NCI initiative designed to promote the adoption of evidence-based cancer control interventions. Once effective interventions are identified, rapid translation into practice needs to occur if we are to assist young people in stopping tobacco use.

Following her presentation, Dr. Backinger was asked whether we have a "magic bullet" or even just a "bullet" for the most effective approaches to youth cessation. The response was that although it would be premature to make any changes in current delivery of services, there is some evidence that looks promising and this has only been made possible by earmarked funding for this purpose.

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