An estimated 28% of high school students smoke cigarettes.  More than half of high school smokers report wanting to quit and try to each year.  The U.S. Department of Health and Human Services (DHHS) recommends that to help adolescents, counseling should be provided and nicotine replacement therapy be considered.  Alternatively, the Food and Drug Administration (FDA) has not approved these nicotine replacement therapy products for any persons under age 18 years. 

Nicotine replacement therapy products are in various forms:  inhalers (generally prescription only), nicotine gum, and nicotine patches.  Nicotine gum and patches have been re-classified to be over-the-counter, non prescription medications.  This study determined the ability of minors (teens under age 18) to purchase over-the-counter nicotine replacement therapies. 

A 15-year old white female (5’ 2’’ tall) was trained to attempt purchasing a nicotine replacement product from 207 groceries, pharmacies, and retail stores in and near Memphis Tennessee.  If asked for proof of age, she was instructed to answer truthfully.  If challenged, she was instructed to leave the store and not to try to purchase the product under the guise that it was for an adult. 

Of the 80% of stores that stocked either nicotine gum, nicotine patch or both, buyer’s age was not asked by 79% .  The minor was able to purchase the product at 81%.  Those who did not sell their product did not do so because the minor was too young or because there was no identification.  Stores that sold alcohol were least likely to sell the nicotine replacement product. 

The authors cite previous research in this area which found three-quarters of adolescent smokers endorsed these products for reasons other than trying to quit smoking.  They also point out that although minors have easy access to nicotine replacement therapy products, they are probably prohibitively expensive for adolescents who wish to abuse them or use them as therapy.  For doctors who prescribe this therapy, it should be recognized that adolescents may have some problems when purchasing them. 

(Johnson KC, et al. Arch Pediatr Adolesc Med 2004; 158:212-216.)        -  H. T.