Smoking Health Article

Smoking

Use of cigarettes and other tobacco products to engage in a habit that almost always leads to addiction.

Every day 3,000 young people light up their first cigarette; every year a million teenagers become regular smokers. Adolescent smoking has risen steadily throughout the 1990s, following a sharp decline in the 1970s that leveled off in the 1980s. A 1994 report by the office of the U.S. Surgeon General found that approximately 28% of teens smoked in 1991 and 1992. By 1995 a survey of high school students released by the Centers for Disease Control and Prevention found that the prevalence of teen smoking had increased to 34.8%. The study also found that smoking was most prevalent among white teenagers (38%), followed by Hispanics (34%), and blacks (19%). In addition to smoking more, teenagers are also starting to smoke earlier. The average teen smokes his or her first cigarette at the age of 13, becoming a regular smoker at 1444. A 1996 survey by the Public Health Service found that 21% of eighth graders and 30% of tenth graders surveyed smoked.

The harmful effects of teenage smoking are known to be both short-term and long-term. During adolescence, smoking interferes with ongoing lung growth and development, preventing the attainment of full lung function. Teenagers who smoke are less fit than their nonsmoking peers and more apt to experience shortness of breath, dizziness, coughing, and excess phlegm in their lungs. They are also more vulnerable to colds, flu, pneumonia, and other respiratory problems. Smoking for even a short time can produce a chronic smoker's cough. In addition to respiratory problems and a diminished level of overall well-being in adolescence, teenage smoking is also responsible for health problems in adulthood.

It is estimated that one-third of the teenagers who start smoking each year will eventually die of diseases related to tobacco use—diseases that will shorten their lives by an average of 12-15 years. Cigarette smoking is a major risk factor for cardiovascular disease, including coronary heart disease, atherosclerosis (hardening of the arteries), and stroke. The 1994 Surgeon General's report links teenage smoking to cardiovascular disease in both adolescents and adults. The same report cites evidence that the length of time a person has smoked has a greater impact on the risk of developing lung cancer and other smoking-related cancers than the number of cigarettes smoked—in other words, starting to smoke at an early age is an even greater health risk than being a heavy smoker.

Several factors have been cited as inducements for teenagers to begin smoking. It is generally agreed that the most important is peer pressure. Having friends who smoke makes smoking appear desirable to teens and makes them feel different or left out if they don't smoke also. (Many teenagers overestimate the prevalence of teen smoking.) At parties or in other social situations, smoking can help teenagers mask or cope with feelings of insecurity or self-consciousness. They also use it—as adults do—to help them cope with a broad range of Stressors and negative feelings. Other factors cited as playing a role in teenage smoking include curiosity, boredom, and the desire to rebel against parents and other authority figures. Teenagers are much less likely to model parental smoking behavior than that of their peers. The main impact parents can have on teen smoking is to actively discourage their children from smoking by discussing its harmful effects and to be supportive of their children in other areas of their lives.

The 6.2 billion dollars that the tobacco industry spends every year on advertising has also been shown to have a significant effect on teenage smoking. In spite of industry denials, teenagers are a crucial market for cigarette manufacturers. Since the vast majority of people who smoke start before the age of 18, this is the prime period during which tobacco companies must make their appeal to potential new customers. And now more than ever they need these customers to replace the many adults lost to the market every year through quitting (in addition to those who die). Although cigarette advertising has been banned on radio and television since 1971, the tobacco industry can still target young people in print ads and, increasingly, through sponsorship of sporting events, concerts, and other types of entertainment. Today's print ads rely more heavily on images than slogans or information, representing smokers as young, healthy, energetic, and stylish. The Surgeon General's report suggests that cigarette ads work not only by associating smoking with a positive self-image but also by making it seem pervasive.

Although it is illegal to sell tobacco to minors, most teenagers report having little trouble obtaining cigarettes. Of the adolescents questioned in the 1995 Centers for Disease Control Youth Risk Behavior Survey, 40% said they regularly bought cigarettes in stores. Thirty-three percent reported borrowing them from others, while another 16% said they usually gave someone else money to buy cigarettes for them. About 4% said they stole cigarettes, and 2% reported buying them from vending machines. In response to the easy availability of tobacco to teenagers, the Food and Drug Administration has included in its new anti-smoking program a regulation requiring store employees to request that all cigarette purchasers who appear to be under 27 years of age provide proof that they are at least 18. This measure, which went into effect at the end of February 1997, will be monitored through undercover inspection, and any merchant found selling cigarettes to a minor will receive a warning and be fined $250 for any subsequent violation.

As the next step in the FDA's program to cut teenage smoking in half within seven years, regulations aimed at the marketing of cigarettes to teenagers were slated to take effect in August of 1997. These include the banning of cigarette advertising on billboards within 1,000 feet of a school or playground; an attempt to reduce the appeal of tobacco to young people by restricting all outdoor cigarette advertising (and advertising in magazines frequently read by teenagers) to black and white ads with no pictures; and a ban on printing the logos of cigarette brands on athletic clothing such as baseball caps, T-shirts, and gym bags. As of August 1998 cigarette manufacturers were to be prohibited from displaying brand names (as opposed to corporate logos) at sporting events.

Although nicotine is considered by some to be as addictive as cocaine, most teen smokers tell themselves that they will be able to control their use of cigarettes. This is usually not the case. Two-thirds of young people who smoke have made at least one failed attempt at quitting. Seventy percent regret having started smoking. Symptoms of withdrawal from nicotine include irritability, anxiety, mood swings, difficulty concentrating, insomnia, depression, headaches, and changes in appetite. Smokers commonly have to try quitting between 7 and 17 times before they succeed. Both the American Lung Association and the American Medical Association (AMA) have launched programs to help teens stop smoking. Additional programs target younger children to prevent them from starting to smoke. The AMA targets children with a superhero called "The Extinguisher," who visits schools and is featured in comic books. A joint outreach program—Teens Against Tobacco Use—has been developed by the American Cancer Society, the American Heart Association, and the American Lung Association. Groups of four teens aged 14 through 17 work with children in grades four through six to inform them about the negative aspects of smoking and serve as positive role models.

Teenage smokers can also obtain help and support from their family physicians, who may be able to prescribe medications that can ease withdrawal symptoms. Call-in hotlines and support groups such as Nicotine Anonymous are also available.