Teens Misusing Nicotine-Replacement Products

Even a few nonsmokers claim they have tried patches or gum

(HealthDay is the new name for HealthScoutNews.)

FRIDAY, June 13, 2003 (HealthDayNews) -- New survey results suggest a small number of teenagers, including non-smokers, are misusing nicotine patches and gum.

The authors of the study warn the teens could be setting themselves up for health trouble if they smoke and use the patch or gum at the same time or if they use the products to maintain their nicotine levels.

But an expert on the psychology of smoking says the students may have lied on the survey. And even if they weren't, that doesn't mean the products are putting them at risk, says Dr. John R. Hughes, a professor of psychiatry at the University of Vermont.

At issue are two over-the-counter drugs that provide nicotine boosts: gum and patches. Smokers use both "nicotine-replacement" products to combat such symptoms of nicotine withdrawal as anxiety, depression and insomnia.

"You don't need much nicotine to relieve that," Hughes says. "People can get 10 percent of the nicotine they normally get and still relieve their withdrawal symptoms."

A third over-the-counter product, the nicotine lozenge, became available too late to be included in the survey.

Study co-author Dr. Karen Johnson, vice chairwoman of the department of preventive medicine at University of Tennessee Health Science Center, became interested in the products during a visit to a store in Memphis.

Although federal officials wanted to keep the products out of reach of minors, "it was out on the counter just like aspirin," she says. "My then-7-year-old son could have bought it."

Johnson and her colleagues launched two studies of young people and nicotine replacement products. Results of the first study, which analyzed use of the products among teenagers, appear in the June issue of The Archives of Pediatrics & Adolescent Medicine. The second study, examining buying habits, will be published later.

For the first study, researchers surveyed 4,078 teenagers from the Memphis area during the 1998-99 school year. Five percent of the teens reported using the nicotine patch or nicotine gum.

Nearly 40 percent of former smokers said they used the products to help them quit. But surprisingly, 18 of those who reported having used the products -- less than 1 percent of all the students -- said they had never smoked.

"It doesn't seem like it would be too appealing," Johnson says. "You don't get that rapid uptake of nicotine and the jolt that a cigarette gives you. That's a little surprising to me."

Some students said they smoked and used the products at the same time, potentially putting them at risk of nicotine poisoning, Johnson adds. A few "were smokers who used the patch (during school) when they couldn't smoke, maybe to maintain their nicotine level. That's not its intended use," she says.

Johnson says more research needs to be done to figure out why teens are misusing the products and how teens could use them to quit smoking.

On the other hand, University of Vermont professor Hughes says he's skeptical of the findings and of the idea that misuse of the products may be worrisome.

The results are questionable because surveys of teenagers can be unreliable, he says. In some studies, teens have admitted using drugs that don't actually exist.

Hughes adds he knows of no medical complications from misuse of nicotine-replacement products.

"If a (nicotine) patch made you drive drunk and run into cars, it would be a different story. Even if you misuse it, it doesn't cause you to have medical problems or mental illness," he says.

The real question, he adds, is whether the products even work in teenagers, who may not be addicted enough to smoking to need them. "We don't know if they're helpful to adolescents," he says.

More information

For a fact sheet on nicotine replacement products, go to the American Lung Association or the American Cancer Society.

SOURCES: John R. Hughes, M.D., professor, psychiatry, University of Vermont, Burlington; Karen Johnson, M.D., M.P.H., associate professor and vice chairwoman, department of preventive medicine, University of Tennessee Health Science Center, Memphis; June 2003 The Archives of Pediatrics & Adolescent Medicine
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