Teens and Tobacco: A Dangerous Bond

The good news is that smoking among teens has decreased substantially since 1996, according to a study of 44,000 students by researchers at the University of Michigan Institute for Social Research. The bad news is that every day, thousands of children under age 18 still try smoking for the first time. Those who continue smoking become addicted adult smokers who face many health problems.

Approximately 90 to 95 percent of all cases of lung cancer are the result of smoking, says Maurie Markman, M.D., director of The Cleveland Clinic Cancer Center in Ohio. Approximately 170,000 new cases of lung cancer are diagnosed each year in the United States. Smoking also is a major risk factor for heart disease, emphysema and lung diseases, as well as contributes to head and neck, stomach and esophageal cancers, and premature death.

Nip the tobacco habit in the bud
"Very few people start smoking after the age of 18 or 20," says Dr. Markman. He puts the blame for adolescent smoking squarely on the tobacco industry, which until recently, heavily marketed cigarettes directly to young people.

"Tobacco is highly addictive, as addictive as cocaine," says Dr. Markman. "Kids become addicted physically and emotionally. They can stop smoking, but it is extremely difficult. It is certainly easier not to start in the first place."

How to help your kids
Parents can play a key role in preventing teens from smoking. "The most important thing parents can do for their children is to not smoke," says Jean Simmons, Ph.D., clinical psychologist at one of the Cleveland Clinic family health centers. "Most kids who smoke have parents who smoke," says Dr. Simmons.

As early as possible�when a child first notices that some people smoke�parents should talk about its dangers, advises Dr. Simmons, who runs group smoking-cessation programs. "Children form ideas about smoking long before they start. De-normalize smoking. Let them know that smoking is not okay for children or adults. In addition to not smoking yourself, do not allow smoking in your home."

Communication is key as well, says Dr. Simmons. "It's important to stay in touch with your children," she advises parents. "Keep talking to them about their lives, school and friends. Get their reaction to any kids they see smoking. If you find out someone has offered them a cigarette, support your children in their desire not to smoke and give them permission to say �no' to friends. Support them in fending off peer pressure."

Kathy Jones (not her real name) has two college-aged daughters, both accomplished athletes, who, unbeknownst to her, started smoking in high school. Kathy, who has never smoked, says her girls began smoking for a number of reasons. "Peer pressure was a big factor. Both had boyfriends who smoked. Low self-esteem came into play. Because their father and I are divorced, they could more easily keep things from us. They also think cigarettes help relieve anxiety. It's like they lead double lives � star athletes on one hand, and smokers on the other." Kathy says her girls have told her that she did not warn them enough about the dangers of smoking when they were young. "Start lectures early�really early," Kathy now emphatically suggests to other parents of teens.

Walking a fine line
If an adolescent has started smoking, have discussion about the damage smoking causes and make it clear to the child that smoking is addictive, says Dr. Simmons. However, parents need to be careful about pressuring teens to quit. "You have to walk a fine line. You want them to know you do not approve of their behavior and would like them to quit without making smoking seem more enticing or making it a tool for rebellion."

While parents may punish their teens or impose consequences when they smoke, Dr. Simmons recommends supporting kids' efforts to quit and to recognize that they may be addicted. Most people do quit on their own, she says, but it often takes several attempts. The keys to quitting are motivation and commitment. "You cannot force anyone to quit. If they are willing, enroll them in a program if they are having trouble quitting on their own," says Dr. Simmons.

"Again, it is crucial that parents do not smoke. Your message about smoking's harmful effects will be negated by the contradictory message you send when you smoke," says Dr. Simmons. "For example, it might make smoking seem like an adult behavior, and more attractive to adolescents."

Smoking and stress
Nicotine is a psychoactive drug that produces a pleasurable sensation of relaxation. But it also causes stress in the form of constricted blood vessels, tensed muscles and elevated heart rate. "Plus, the pressure to quit, high cost of cigarettes and the increasingly negative social perception of smoking actually cause stress for the smoker," says Dr. Simmons.

"Six months after quitting smoking, people report feeling less stress in their lives and higher self-esteem," Dr. Simmons says. "They develop healthier and more productive coping strategies."