Teens and smoking: What parents can do

If you can help your teenager resist taking that first puff of a cigarette, you will dramatically improve his or her odds for a longer and healthier life.

Nearly 90 percent of adult smokers took up the habit before they turned 19 - in other words, before they were old enough to realize they might not live forever. By middle age, they've learned otherwise, often in the hardest way possible. One out of every three smokers can expect to die of a disease caused by cigarettes.

If you can help your teenager resist taking that first puff, you will dramatically improve his or her odds for a longer and healthier life.

What's the attraction?
Adolescents turn to tobacco for a variety of reasons. Perhaps it's a form of rebellion, or maybe they just want to fit in with a particular group of friends. They may believe cigarettes will improve their concentration or help them lose weight.
Some teenagers see smoking as part of their identity or persona. They may feel more macho, sexy, independent or grown-up when they smoke.

An addictive drug
Nicotine is the addictive substance in cigarettes. For some people, it is as addictive as heroin. Nicotine enhances the release of a number of brain chemicals (neurotransmitters) that are associated with pleasure, appetite suppression and relaxation.
Most adolescents believe they can quit smoking anytime they want. But they become just as addicted to nicotine as adults do. In fact, adolescents typically become addicted at relatively low doses of nicotine. A teenager who smokes just one cigarette a day may have withdrawal symptoms when he or she tries to quit.
Seventy percent of adolescent smokers wish they had never started. Two-thirds have made at least one unsuccessful attempt to quit.

Helping them quit
Nearly 23 percent of high-school students and more than 10 percent of the middle-school students in the United States smoke cigarettes.
Lecturing about the evils of tobacco does more harm than good. Warning about the long-term health effects of smoking isn't effective, either. A better approach is to focus on problems that cigarettes may be causing them now:

  • Chronic cough

  • Reduced stamina

  • Bad breath

  • Yellow teeth

  • Stinky clothes

Another factor is the expense. A pack of cigarettes a day costs more than $75 a month - nearly $1,000 a year. That would buy two movie tickets or a music CD every week.

Nicotine replacement
Researchers are now investigating whether nicotine gum or patches are safe and effective smoking cessation aids for adolescents. But because some research suggests that adolescents tend to use nicotine replacement therapy inappropriately, it may do more harm than good.
In a 2003 survey of more than 4,000 adolescents, 30 percent of current or former smokers had used nicotine replacement products while continuing to smoke - a medically dangerous practice. Among adolescents who had never smoked, 18 percent also reported using nicotine patches or gum.

Associated risks
Teenagers who have a best friend or parent who smokes are more likely to start smoking themselves, partly because they have easier access to cigarettes. Poor school performance and cigarette smoking also seem to be related. Teenagers who do well in school seem less likely to start smoking.
Race is another risk factor. White adolescents are much more likely to start smoking than their black or Asian counterparts.
Children who begin smoking at an early age also are more likely to engage in other risky behaviors, such as alcohol use, drug use and unprotected sex. They also have a greater risk of becoming long-term smokers.

Other forms of tobacco
Regular cigarettes aren't the only tobacco risk for adolescents. Some teenagers use cigars, smokeless tobacco or candy-flavored cigarettes imported from overseas - in the mistaken belief that they are less harmful or addictive. Even middle-schoolers use these alternative forms of tobacco. For example, 6 percent of middle-school students smoke cigars. This percentage doubles for high-school students.
More than 2 percent of American high-school and middle-school students smoke bidis (bee-dees) or kreteks (cree-techs). Bidis are small, thin, hand-rolled cigarettes imported from India. They can come in sweet flavors such as chocolate, cherry or mango. Kreteks are also known as clove cigarettes. Both deliver higher concentrations of nicotine, carbon monoxide and tar than conventional cigarettes do.
Some adolescents favor smokeless tobacco, possibly because of its popularity with baseball players and race-car drivers. Users place the product between the cheek and gum, then suck on it and spit out the juices. This form of tobacco is more popular with boys than with girls, with 11 percent of high-school boys and 5.6 percent of middle-school boys using it.
Smokeless, or "spit," tobacco causes oral cancer and can lead to nicotine dependence. Teenagers who use smokeless tobacco are more likely to become cigarette smokers.

Girls versus boys
In 2001, the rates for cigarette smoking were about the same for adolescent boys and girls. At that time, girls' smoking rates had remained steady for 13 years, having risen substantially since the 1970s. Over the same period, however, boys' smoking rates had steadily declined.
One explanation for this difference may be that girls are more likely than boys to start and continue smoking in an effort to control their weight. The higher rates of depression girls experience also may play a role in their smoking, as depression is common among smokers of both sexes.
In addition, girls become dependent on cigarettes more quickly than boys do. Adolescent boys typically develop symptoms of nicotine dependence in 183 days, compared with 21 days for adolescent girls.

Be a good example

If you smoke, quitting is one of the best things you can do to help keep your children off cigarettes. Only 2 percent of adolescent smokers have nonsmoking parents. By contrast, 15 percent of adolescent smokers have both a mother and a father who smoke.

If you can't stop smoking, do the next best thing:

  • Don't smoke in your children's presence.

  • Avoid smoking in the house or car.

  • Don't offer cigarettes to your children.

  • Don't leave cigarettes where your children can get to them.

Parental disapproval of smoking, even from smoking parents, can help prevent adolescent smoking. Counseling children not to smoke must begin in grade school, since 25 percent of adolescents have smoked an entire cigarette before age 13. You may want to role-play with your grade-schooler, helping him or her practice what to say if offered a cigarette.

Helpful middle-school programs focus on:

  • Resisting peer influence to smoke

  • Educating students about the negative social effects of smoking

  • Decreasing the acceptability of tobacco use by young people

While your children may not have a strong desire to start smoking, they may lack a strong resolve to not smoke. Adolescents who lack this anti-smoking resolve are more likely to take up the deadly habit.

Countering the smoking mystique
To counteract the glamorized image of cigarette smoking in advertisements and movies, show your children how smoking has affected the health of your relatives and friends. Point out that smoking is allowed in fewer and fewer public places, and that a growing number of people ban smoking from their homes.
It seems cruelly ironic that smoking often begins as teenage rebellion - an attempt to assert independence. The end result, though, is dependence on a product that is responsible for more than 400,000 deaths a year. Keeping your children smoke-free will greatly increase their chances of living long, healthy lives.



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