Youth tobacco use cessation: 2008 update

Tobacco use is the most prevalent lifestyle-related cause of death worldwide [1,2]. Investigation of the prevalence of a regular pattern of tobacco use is illuminating. Daily cigarette smoking prevalence in the United States increases from approximately 4% among 12 year olds, to 8% among 16 year olds, 12% among 18 year olds, 15% among 20 year olds, and levels off among 26 year olds at 22%, and then drops by 4% among older age groups [3]. A similar pattern of regular smoking develops among youth in other countries, with some variation in the age range and steepness in increase [4]. The relatively steep daily smoking inflexion curve evident during the teen years supports the assertion that teen tobacco use cessation programming is needed among the world's youth [5] (also see http://www.globaltreatmentpartnership.org/treatment_case.html webcite, accessed on 12-20-07). In addition, internationally approximately 60%–85% of young tobacco users are likely to have made at least one quit attempt and failed [6-12]. It appears that youth do want to quit tobacco use, and most appear unable to quit on willpower alone [13].There have been 8 systematic reviews of the teen smoking cessation literature thus far. First, Sussman, Lichtman, Ritt, and Pallonen [14] evaluated 34 programs, 17 smoking cessation trials and 17 smoking prevention trials for their impact on cessation of cigarette smoking. Sussman [15] provided an enlarged review of 66 cessation trials (which included single-subject designs), and 17 studies of self-initiated quitting. McDonald et al. [16] provided a re-review of the Sussman [15] study. Garrison et al. [17] reviewed 6 studies of relatively rigorous designs. Backinger et al. [18] did a qualitative review of prevention and cessation programs.Then, Sussman, Sun, & Dent [10] completed the first formal meta-analysis of 48 studies, which included both experimental and quasi-experimental designs. Shortly thereafter Grimshaw & Stanton [19] provided a 2006 Cochrane meta-