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Nicotine Patches for Teens: Why an Illinois High School Said No

Timothy NoahPosted Wednesday, April 4, 2001, at 7:42 PM ET

Last week, Chatterbox pondered the advantages of permitting high schools to dispense nicotine patches and nicotine gum to teen-aged cigarette addicts. The pluses seemed to outweigh the minuses, chief among the latter being the apparent necessity of having a doctor prescribe the nicotine products (they're sold over-the-counter for adults, but not for minors), coupled with the powerful, and generally sensible, reluctance schools have about handing out drugs of any kind. These turn out to be the reasons why Vanguard School in Illinois, after supposedly thinking it over, decided against starting a nicotine-patch program.

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In fact, according to Vanguard School principal Jan Schneider, "the school did not consider it." What happened was this: A year ago, one Dr. Arvind Goyal was invited to speak at Vanguard's annual Health Day. Goyal, a family practitioner who belongs to a municipal committee in nearby Rolling Meadows called the Tobacco Information and Prevention Program (TIPP), asked a group of 10 Vanguard students whether any were smokers. Nine were. Then Goyal started reciting the familiar litany of gruesome health statistics concerning people who smoke. None of this was news to the kids. Finally, Goyal asked them what it would take to quit. One student said he'd use the patch if he could afford it. Goyal then asked whether the other kids would try the patch if it were given to them free. Seven out of the 10 said yes.

Struck by this response, Goyal persuaded TIPP to try to work up an experimental nicotine-patch program for Vanguard. SmithKline expressed some interest (though it emphasized that this would have to be a scientific study of limited duration, not an ongoing program, and that even then the drug might not be provided gratis, and that all sorts of procedures for counseling and whatnot would need to be developed). Goyal next approached Schneider at Vanguard School. The two discussed it a few times. But, Schneider says, it was an unworkable idea from the get-go. "I can't even distribute an aspirin to a student, let alone a nicotine patch," she told Chatterbox. Well, sure, she can't, because she isn't a doctor. Here's the relevant passage from the Illinois School Code, "Administering Medication":

It shall be the policy of the State of Illinois that the administration of medication to students during regular school hours and during school-related activities should be discouraged unless absolutely necessary for the critical health and well-being of the student. Under no circumstances shall teachers or other non-administrative school employees, except certified school nurses, be required to administer medication to students. ... This Section shall not prohibit any school employee from providing emergency assistance to students.

Mr. Justice Chatterbox isn't so tendentious as to argue that a high-school student's addiction to smoking is a condition requiring "emergency assistance." But he does think smoking cessation is "necessary for the critical health and well-being of the student." This is a loophole Chatterbox can work with! If the prohibitions in other states are worded in similarly vague language, getting nicotine patches into schools shouldn't be all that difficult. At the very least, Vanguard School should give Goyal's nicotine-patch scheme a second look.

E-mail Timothy Noah at .

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Timothy Noah is a senior writer at Slate.

COMMENTS

Reader Comments From The Fray:

The main problem with distributing nicotine patches in high schools is medical, not legal. To put it another way, legal restrictions on schools administering medications may be unnecessarily cautious in many settings, but in this case, the law is right.

The vast and overwhelming majority of people who have quit smoking have done so without any medication. All medications have side effects. It is wrong to use an approach that involves medication first, if most people will do well with more conservative measures, namely, just quitting. Adding a medication has only been shown to marginally improve the chances of success, and even that improvement only holds up if the medication is supervised and used in conjunction with a support or encounter group. Even this limited and qualified success has been demonstrated only in populations of smokers who have typically failed multiple attempts at just quitting on their own.

Distibuting nicotine patches in high schools sounds like a great idea for the bottom line of the drug companies (Phillip Morris should get into this business, they have plenty of experience managing mass addictions to maximize profits), not a great idea for the health, immediate or long term, of teenagers.

--Glen Tomkins

(To reply, click here.)

We suggest that Chatterbox call his local hospital and inquire of them where one might find a patient with a critical health condition. Then see if they direct him to a smoking cessation workshop

--David W. Rochlin

(To reply, click here.)

To David W. Rochlin:
That's the thing about smoking--it takes delicious decades to get you, so in the sense of urgency or emergency, the term critical does not apply.

However, in the sense of the word as meaning an important juncture or turning point, then Chatterbox is correct, as most of those (us) who become serious cigarette addicts began as teens. Intervention at this point could fairly be termed critical.

--Sally

(To reply, click here.)

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