Learning Objectives: Create a protocol to assist health care providers with the treatment of adolescent tobacco use.
Abstract: OBJECTIVE:
To create a protocol to treat adolescent tobacco use, and make a recommendation regarding the use of nicotine replacement therapies with adolescents, given the fact that there is little scientific data regarding effective tobacco treatment for adolescents using behavioral counseling or nicotine replacement therapies. At the time of Vermont’s policy, NRT for adolescents was not recommended for use by the FDA.
METHODS:
A literature search was conducted regarding treatments including the effectiveness and safety of using NRT with youth. The data was presented to the Department’s Scientific Advisory Committee, a committee consisting of the Commissioner of Health, public health specialists, physicians, researchers, and scientists from the University of Vermont.
RESULTS:
After reviewing the research, a protocol was developed for health care professionals treating adolescent patients who smoke, based on the 4 A’s (Ask, Advise, Assist, Arrange for follow-up). Regarding NRT, the Health Department stated that the use of NRT with youth is not currently recommended due to lack of evidence of it’s efficacy. A protocol card was created that is currently included in a Provider’s Tool Kit, a science based schedule of preventive health care resources, given to every pediatric office in the state.
DISCUSSION: Demand for effective smoking cessation programs and treatments for adolescents is high, and providers need to have current guidance. Based on the available research, Vermont provided guidance based in the US Public Health Service guidelines, while educating physicians that there is not yet enough scientific evidence to recommend the use of NRT with youth.
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