Treating Tobacco Dependence in Adolescents With Co-occurring Psychiatric Disorders

Completed · Phase 3

Conditions studied: Tobacco Use Cessation, Tobacco Use Disorder

In brief

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).

Key facts

Study ID

NCT00618943

Run by

University of California, San Francisco

People needed

60

Starts

2008-04-01

Expected to finish

2010-04-01

Last updated by the study team

2011-12-08

Who can join

Age: 13 and older, up to 25. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• receiving active outpatient psychiatric care
• report smoking at least 1 cigarette in the previous 30 days and at least 100 cigarettes in their lifetime
• Other inclusion criteria are: no plan to relocate outside of the greater San Francisco Bay Area in the next 12 months and telephone access for scheduling follow up assessments.

You may not qualify if…

• cognitive impairment precluding ability to participate
• non-English speaking
• currently engaged in tobacco treatment
• Recruitment of acutely psychotic, manic, or hostile patients will be delayed until there is significant reduction of these symptoms and patients are able to assent to study participation

Where it is running

• Edgewood Center for Children and Families — San Bruno, California, United States
• UCSF Langley Porter Psychiatric Institute — San Francisco, California, United States
• San Mateo County Mental Health — San Mateo, California, United States

Full record on ClinicalTrials.gov

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