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Cigarette Taxes, Antidepressants Could Help Teens Quit
> 11/6/2007 1:23:38 PM

The vast majority of smokers start young, at least partially becausethey're less likely to heed or carefully consider the dire warningsprinted on every pack of cigarettes and reinforced by parents, teachersand ad campaigns. The tobacco industry's barely-disputed practice of advertising to underaged teens (but not children,you see) through magazine and convenience store spots also plays a rolein ensuring that thousands of 14 and 15-year olds across the countrytake that first puff every day.

By the time they finish highschool, a majority of kids have tried at least one cigarette. What'sthe appeal? For many, smoking serves as an assertion of independencehinting at maturity, a (terrible) decision made on one's own volition.Kids are not blind to the painfully obvious health risksposed by smoking, but the promise of addiction and cancer in 40 or 50years seems very distant to a 15-year old, and once they've startedthey find quitting to be exceedingly difficult (like all othersmokers). A majority of teen smokers voice a real desire to quit, butonly 4% of those who try are able to eliminate tobacco from theirlives. While no one can rationally promise a miracle cure, medicine andtechnology will continue, through miniscule advances, to make thequitting process easier for young smokers than it was for previousgenerations. New research confirms the previously proposed role of the antidepressant bupropion (commonly sold as Zyban or Welbutrin) as a tepidly effective smoking cessation tool.

Thebupropion connection came about when some smokers who'd taken the drugin its original role as antidepressant noticed a decreasing desire fortobacco. Previous studies have noted its potential as a stop-smoking aide, but their patient groups consisted of adult smokers. The new studyincluded more than 300 students aged 14-17 who smoked at least sixcigarettes a day and had tried to quit more than once in the past. Theteens were divided into three groups, some of whom received varyingdoses of bupropion. They were then treated and monitored for sevenweeks and subsequently interviewed at 12 and 26 weeks. During theinitial treatment period, results were overwhelming: only 5.6% of theplacebo group had quit smoking after seven weeks. 10.7% of those whotook 150mg of bupropion each day and 14.5% of those who took 300mg hadstopped. Later results, while still positive, were somewhat lessencouraging, as many of the patients resumed their old habits: at 26weeks, 3.1% of the 150 mg group, 10.3% of the placebo group and 13.9%of the 300 mg group remained smoke-free, according to personaltestimony and urine tests. While researchers could not quite explainthe strange dip in abstinence among the 150 mg group, substantial dailydoses of bupropion do seem to help smokers stay away. Further researchwill, of course, offer a more complete assessment.

Money alsomakes a very obvious weapon for deterrence. Teens work with limitedfinancial means, and the act of legally raising cigarette prices, whileeliciting grumbles of discontent from thousands of smokers andunwavering free-market advocates, has the potential to discourage teensfrom buying tobacco. They may very well find other sources for thedeadly leaf, but any legislation that could even slightly move tobaccostatistics in the right direction should be encouraged. Some states areconsidering the example set by New Jersey, which voted to approve thenation's highest tax on cigarettes and now boasts the lowest levels ofsmoking among its middle and high-school students. The nature of thiscausal relationship remains somewhat vague ("Experts estimate that a 10-percent increase in price reduces overall cigarette consumption 3 to 5 percent"),but the fact that the tobacco industry spent $10 million dollarsattempting to derail similar legislation in the state of Oregon speaksvolumes about its efficiency.

On the plus side, we've yet to sink to the lows of the Australianschool that has, on physician's recommendation, allowed for anunderaged(!) student to take school-approved smoke breaksduring the day due to her "clinical addiction" to nicotine. This caseis a ridiculous anomaly useful only in illustrating the malevolent (andcancerous) influence that tobacco holds over its addicts. Provingaddiction in a laboratory should not lead to an institutional allowanceof the harmful behaviors that it entails. Many would object if, forexample, the school required the student to attend smoking cessationseminars like those in the study mentioned above. But that move wouldactually make a lot more sense.

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