TOP > Projects > Past Projects > brownU > Vol.21, No.12, December 2005 - Keep Your Eye On...decline in pediatric antidepressant prescribing - Study looks at teen smoking-cessation media campaign


Vol.21, No.12, December 2005 - Keep Your Eye On...decline in pediatric antidepressant prescribing - Study looks at teen smoking-cessation media campaign

Two-year data from NDC Health Inc. indicate that the number of antidepressants prescribed to patients 18 years and younger has declined nearly 20% since March 2004. Since the FDA's public health advisory of a possible association between antidepressants and increased risk of suicide, and subsequent implementation of black box warnings, the downward shift in prescribing patterns raises the question of whether children and adolescents with depression who are no longer taking antidepressants are receiving effective and appropriate treatment options, or any type of care at all. According to Thomas Insel, M.D., Director of the National Institute of Mental Health (NIMH), "NIMH has large studies under way looking at whether the decrease in SSRI utilization might be associated with an increase in suicidality rather than a drop in suicide, and my expectation is that we may see an increase." Adelaide Robb, M.D., Children's National Medical Center, Washington, D.C., suggests that the data are "worrisome," and questions if there has been a corresponding increase in non-pharmacological treatments such as cognitive behavioral therapy or other types of treatment that are known to be effective in adults.
[Rosack J: Psychiatr News 2005; 40(17):1.]

Study looks at teen smoking-cessation media campaign

A smoking-cessation media campaign,, appears to be an effective internet source to help adolescents who want to stop smoking. According to a telephone survey evaluating the results of the media campaign, nearly all teen smokers reported that they wanted to stop smoking. Nearly 1 out of 4 survey respondents who were trying to quit had visited or another website for assistance with smoking cessation.

According to researchers, Jonathan D. Klein, M.D., and colleagues, these results are consistent with other studies showing that adolescents are motivated to stop smoking. The findings of their own survey, they say, demonstrate the effectiveness of web-based cessation resources for adolescents who are highly receptive to messages communicated on the internet. With the tobacco industry spending nearly $7 billion yearly on advertising, Klein and colleagues believe that counter-strategies aimed at smoking cessation must be established. "This is the first report of a community-based cessation campaign that integrated Web adjuncts with mass media messages targeting youths."

The media campaign was introduced in January 2001 in Monroe County, New York. The campaign was promoted through paid advertising on radio, television, billboards and city busses. In addition to informational content, the website also offered a chat forum for adolescents to speak with a trained quit coach and former smoker.

The survey was carried out in 3 phases. A pre-campaign telephone survey was conducted 1 year before was launched. A post-campaign survey was carried out one year after was launched to assess demographic information, receptivity to the media campaign, and degree of media use based on the amount of time respondents spent listening to the radio, watching TV or using the internet. Another follow-up survey, the Monroe County Youth Risk Behavior Survey (YRBS), was carried out in 2003 in 32 schools.

The results for self-reported tobacco use were comparable between the pre- and post-campaign surveys. Respondents were 14 years old, on average, when they first began smoking. In both surveys, respondents currently smoking were significantly more likely to be older than non-smokers. Most of the current smokers thought they were addicted to nicotine. Post-campaign results showed that white teens were more likely to be current smokers than black teens of teens of other ethnic groups.

Results showed that the majority of smokers wanted to stop smoking completely (87.3% pre-campaign, and 73.5% post-campaign). Smokers from the post-campaign survey were more likely to have seriously tried to quit smoking cigarettes and had tried to quit more times than pre-campaign smokers. Nearly all of the website users who reported smoking had visited the website. In the YRBS survey, 11% had visited or another website for help in quitting.

The authors conclude that while research suggests that adolescents may be in need of cessation interventions, many of them are not aware of smoking-cessation programs; some of them may also have concerns regarding issues of confidentiality, fears of possible parental involvement, or speaking to counselors who cannot relate to their experiences. A non-judgmental online resource may be of greater benefit to adolescents who are seeking help in breaking the habit.

Klein JD, Havens CG, Carlson EJ: Evaluation of an adolescent smoking-cessation media campaign: Pediatrics 2005; 116(4):950-956.

The Brown University Child and Adolescent Behavior Letter, December 2005
Reproduced with permission of John Wiley & Sons, Inc.
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