Interventions aimed at young people to help them stop smoking have had only limited success and there is an urgent need for innovative and effective programmes to which young people will subscribe, says an editorial published on bmj.com today.
Although many smoking cessation interventions for young people have been tested, the evidence of their effectiveness in helping young people quit before smoking becomes addictive and ingrained is poor, write Gill Grimshaw from the University of Warwick and Alan Stanton from the Solihull Care Trust.
In the UK around 12% of teenagers are regular smokers and this rises to 35% in some parts of the world. It is well known that people who start smoking at a young age are more likely to smoke for a long time and are more likely to die prematurely from smoking related disease.
Research has shown that young smokers make repeated attempts to quit and around 70% express a desire to quit shortly after taking up the habit.
So why are interventions to help young people quit smoking not working?
Data published in 2006 showed that there is a lack of good quality evidence available to show what works or to recommend widespread implementation of any one programme.
The authors point to a review of several Scottish NHS programmes which found that a key problem was recruiting young people into the programmes. After one year, only 11 young people (2.4%) from all seven projects had managed to quit long term. These findings and others from studies outside the UK suggest that one of the main barriers to implementing smoking cessation interventions is the practicalities of working with organisations and young people.
According to the authors, part of the problem is that young people do not see themselves as lifelong smokers and quitting is not an urgent priority, while smoking cessation services are often viewed as being for older more addicted smokers.
In addition, only nicotine replacement therapy is currently licensed for use in young people, and because it is well known that smokers tend not to reuse strategies that have failed them previously, they suggest that it may be better to save these strategies for when success is more likely.
The authors conclude that although we don't know what works, young people still need support when making attempts to quit, and privacy, confidentiality, respect and an absence of pressure are also important.