While efforts to better educate teenagers and parents about the risks of smoking have been somewhat successful, the American Lung Association estimates that there are still 4-5 million teenage smokers. Many of the quitting techniques found effective for adults are copied for teenagers, but this assumes that the minds, bodies, and addictions of teenagers are exactly the same. A study by Dr. Mark Rubenstein, published this month in Pediatrics, demonstrates that one such technique, nicotine nasal sprays, does not work for teenagers.

Dr. Rubenstein began his study optimistic about the power of nicotine nasal spray because of its fast-acting and easily adjustable dosages, and its solid record with adults. He gathered 40 daily smokers aged 15-18 and divided them into a therapy and nasal spray group or a therapy-only group. After three months, the therapy-only group achieved just as many smoking-cessations as the group that had the additional help of nicotine spray.

There are many possible explanations for why the nasal spray did not show any benefit for teenagers. Previous studies with nicotine patches found that teenagers did not receive proper dosages and suffered troubling side-effects like nightmares and increased irritability. It is possible that nasal sprays that are perfectly calibrated for adult bodies are not delivering the correct amounts to teenagers. While no nightmares were reported in Dr. Rubenstein’s study, 34.8% described uncomfortable burning sensations and 13% found the taste and smell of the spray repugnant.

It is unclear whether the burning sensations and bad tastes are caused by a difference in teenager physiology, or by the fact that teenagers are less likely than adults to stoically accept treatment. More than half of the teenagers admitted that they missed dosages or stopped using the spray entirely after the first week. If teenagers are not actually suffering worse side-effects from the spray than adults, this suggests that they are much less likely to properly use cessation tools in general.

This study clearly shows that nicotine nasal sprays, at least in their current form, are not effective with teenagers. It also serves as another reminder that teenage addiction is in many ways unique, and thus often requires an approached tailored to their unique physiologies and dispositions. Doctors and parents trying to help teenagers quit should pay close attention to not only nicotine levels but the emotional levers that might cause a child to conscientiously use a cessation tool every day or abandon it because it appears uncool or distasteful.