Applying a Social–Ecological Framework to Factors Related to Nicotine Replacement Therapy for Adolescent Smoking Cessation

Abstract

Objective: This systematic review synthesizes factors related to nicotine replacement therapy (NRT) use among adolescents seeking to quit smoking, using the social–ecological model as a guiding framework. Data Source: Searches of PubMED, ProQuest, EBSCOhost, and ERIC were conducted in July 2016. Study Inclusion and Exclusion Criteria: Original studies of cigarette smokers younger than 18 years that discussed NRT were included. Data Extraction: Two reviewers individually extracted study purpose, sample, design, and results. Data Synthesis: Factors were categorized by social–ecological model level and summarized. Results: A total of 103 907 articles were identified during initial search. After narrowing to peer-reviewed articles in English and eliminating reviews and adult-only studies, we reviewed 51 articles. These 51 articles identified factors from studies at each level of the social–ecological model: intrapersonal ( k = 20), interpersonal ( k = 2), organizational ( k = 7), community ( k = 11), and public policy ( k = 14). Conclusion: Findings provide insight into the applicability of NRT for adolescent smoking cessation, and factors by social–ecological model level highlight areas for additional research. Future adolescent NRT studies should assess factors at the interpersonal, organizational, and community levels, as well as the interactions between levels.