, 2004; Maes et al., 1999, 2006). Finally, it is important to note that time to first www.selleckchem.com/products/FTY720.html cigarette played an important role in class membership��those in the MDMF class were more likely to endorse smoking their first cigarette over an hour after waking (37.6%) compared with only 14.5% of those in the LSMF class. Recent studies (Baker et al., 2007; Haberstick et al., 2007; Muscat, Stellman, Caraballo, & Richie, 2009; Niaura, Shadel, Goldstein, Hutchinson, & Abrams, 2001) have begun to focus on the salience of time to first cigarette as a marker of phenotypic and genetic vulnerability to problematic smoking, and our analyses underscore the need for studies focused on this aspect of the FTND.

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Almost all adult smokers began smoking during adolescence, and youth smoking rates range, in steadily increasing numbers, from 6% of 14-year olds to 37% of 21-year olds (Backinger, Fagan, Matthews, & Grana, 2003; Substance Abuse and Mental Health Services Administration, 2008). Daily smoking, a particularly concerning predictor of long-term smoking and adverse health outcomes, is uncommon in younger adolescents (3% of 8th graders, 7% of 10th graders), but increasingly prevalent as older adolescents transition into adulthood (11% of 12th graders and 17% of 21-year olds; Johnston, O��Malley, Bachman, & Schulenberg, 2011; Substance Abuse and Mental Health Services Administration, 2008). Nearly two-thirds of young smokers may be interested in quitting, but only 4%�C6% of unassisted quit attempts are successful (Chassin, Presson, Pitts, & Sherman, 2000; Stanton, McClelland, Elwood, Ferry, & Silva, 1996; Zhu, Sun, Billings, Choi, & Malarcher, 1999).

Surprisingly, few controlled studies have evaluated adolescent smoking cessation programs, and almost all have exclusively focused on psychosocial treatments, yielding generally discouraging results. For example, a meta-analysis of 48 studies showed a mean quit rate of 9.1%, compared with 6.2% among control groups (Sussman, Sun, & Dent, 2006). In the interest of enhancing these modest quit rates, and in light of clear evidence that adolescent smokers experience nicotine withdrawal and craving (Jacobsen et al., 2005; Killen et al., 2001; Prokhorov et al., 2001), a handful of recent studies have explored the potential impact of pharmacotherapy for adolescent smokers.

Only six controlled cessation trials to date, most enrolling predominantly older adolescents, AV-951 have investigated bupropion SR (Gray et al., 2011 [mean age 18]; Killen et al., 2004 [mean age 17]; Muramoto, Leischow, Sherrill, Matthews, & Strayer, 2007 [mean age 16]) and/or nicotine replacement therapy (Hanson, Allen, Jensen, & Hatsukami, 2003 [mean age 17]; Moolchan et al., 2005 [mean age 15]; Rubinstein, Benowitz, Auerback, & Moscicki, 2008 [mean age 17]). Results, while mixed, suggest that some pharmacotherapies may complement psychosocial treatment and enhance cessation outcomes.