MedWire News:: Teenage smokers are no more likely to quit the habit if they receive a nicotine replacement nasal spray in addition to counselling, US research shows.

Smoking is associated with an increased risk of many diseases and conditions, including chronic obstructive pulmonary disease, cardiovascular disease and various types of cancer. It is therefore important to help young smokers quit the habit before their health starts to suffer.

Dr Mark Rubinstein, from the University of California in San Francisco, and colleagues explain that studies show that nicotine replacement therapy in the form of patches, nasal sprays and gum can significantly improve quitting rates among adult smokers.

But they add that less is known about the effectiveness of nicotine-replacement therapies among teenage smokers.

To investigate, the researchers studied 40 teenagers, aged between 15 and 18 years, from several US high schools, who had smoked at least five cigarettes a day for 6 months or longer.

The participants received either weekly smoking cessation counselling for 8 weeks, or 8 weeks of counselling in combination with the use of a nicotine replacement nasal spray for 6 weeks.

Twelve weeks later, the researchers found that smoking cessation rates, the number of cigarettes smoked a day and levels of nicotine in saliva did not differ significantly between participants who received counselling alone and those who also received the nasal spray.

Furthermore, after just 1 week, 57% of teenagers assigned to take the nasal spray stopped using it because of side effects, such as nasal irritation and burning, and complaints about the taste and smell of the spray.

Writing in the journal Pediatrics, Dr Rubinstein and team conclude: “The unpleasant adverse effects, poor adherence and consequent lack of efficacy observed in our pilot study do not support the use of nicotine nasal spray as an adjunct [addition] to counselling for adolescent smokers who wish to quit.”