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

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.