Adolescents who voluntarily join stop-smoking programs are typically more addicted to nicotine than their peers and also more likely to use smokeless tobacco or smoke cigars, according to new research from West Virginia University.

Researchers based their conclusions on a study of 6,000 teen smokers enrolled in Not On Tobacco (NOT), a school-based intervention program developed at West Virginia University. The findings could help preventionists do a better job of attracting young smokers to the NOT program and countering the marketing efforts of the tobacco industry, the authors said.

Students who volunteered for the NOT program wanted to quit, but often lacked confidence in their ability to do so. Unlike most teen smokers, who are considered only moderately dependent on nicotine, "The NOT teens were not experimental smokers. They were moderately to highly nicotine dependent," said study author Kimberly Horn. "The teens who volunteered for NOT had started smoking earlier than others and had also made more previous attempts to quit."

The study was published in the journal Tobacco Induced Diseases.