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Some Schools Helping Kids Unhook the Smoking Habit

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Douglas Jorenby, PhD, clinical services director of the University of Wisconsin Center for Tobacco Research and Intervention in Madison, warns of possible complications in using the patch for adolescents and distributing it through schools.

"In theory, it's a wonderful idea," he says. "But there are potential complications: If they are under 18, they can't buy the patches so their parents would have to buy them or a physician would have to give them a prescription."

Patches are available over the counter but only for those over 18, because nicotine use -- as are cigarettes -- is illegal for those who are younger.

Another problem with more serious implications is the possibility of nicotine poisoning if the patch is worn while smoking at the same time. This could be especially dangerous for teenagers because, Jorenby says, "adolescents tend to be more impulsive in their smoking."

He disagrees with Hurt as to teens' motivation to quit smoking. He says most teens don't want to quit, while the Mayo Clinic researcher says their study showed they did. "We were encouraged that so many of them wanted to quit," Hurt says. "It's mythology in the public that teens don't want to stop."

However, Patricia Chandler, MD, of the University of Texas Southwestern Medical Center at Dallas, says the biggest problem she faces in working with youngsters addicted to cigarettes is their lack of desire to kick the habit. "They don't want to," Chandler says. "It's a prestige thing. And dancers smoke because they think it will keep the weight off." Chandler is a family practice doctor specializing in addictions.

Nevertheless, some schools think they can help wean these easily hooked youngsters off what's sometimes called the cancer stick, since smoking is responsible for about one-third of all cases of cancer in America.

School health clinics in Multnomah County, Ore., have given a few students nicotine patches over the past three years, and a school in the Chicago suburb of Arlington Heights is considering it as well. Hurt and Jorenby both believe the Oregon distribution through school-based health clinics system is an option. "If they are smoking in school restrooms, then it becomes a public health hazard," Jorenby says.

Other educators don't think they should be responsible for this type of treatment. Richard Adams, MD, Dallas Independent School District medical director, says it's unlikely to happen in schools in the Dallas area. He says that no one has instituted a district-wide smoking cessation program for students.

"The board of education doesn't see our role as providing general health treatment," Adams says. "If a student is on a prescription from a physician that must be taken during school, then we will administer it. However, we feel something like using the nicotine patch should be the decision of the physicians and the parents."

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