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Stamping Out Teen Smoking

Teen Smoking Rates Decline, but Quitting Is Still a Challenge

Sixteen-year-old Haley A.'s New Year's resolution is to not criticize other people. As admirable as that goal may be, Haley's mother wishes her daughter had made another resolve: to quit smoking. But the teen is indifferent to the idea. She enjoys smoking, and at five or six cigarettes a day, does not believe she is addicted to nicotine.

"I think if I had something to motivate me, I could stop really easily," Haley says. "For me, it's a boredom thing. Whenever I'm bored, it's something to do."

The honor roll student who says she's the only smoker in her circle of friends is bucking a national trend. Monitoring the Future, a new survey released by the U.S. Department of Health and Human Services and the University of Michigan's Institute for Social Research, shows teen smoking in grades 8, 10, and 12 is declining "at a vigorous pace." This is a direct contrast to the early 1990s, when researchers saw a dramatic increase in the number of teens lighting up. Among eighth-graders, smoking rates fell from 21 percent in 1996 to 12 percent in 2001; and among tenth-graders, from 30 percent to 21 percent. Among high-school seniors, smoking rates dropped from 37 percent in 1997 to 30 percent in 2001.

The study attributed the decreases to the demise of the Joe Camel ad campaign, the increase in anti-smoking ads, and the jump in cigarette prices in most states.

"Young people are price-sensitive in their use of cigarettes," says the study's principal investigator, Dr. Lloyd D. Johnston of the University of Michigan. "When the price goes up, it is less likely that (kids) will proceed to greater use."

Parents, Not Just Media, Need to Send "No Smoking" Signals

What about the influence of parents? While the latest survey didn't ask teens to describe parental influence, anti-smoking activists insist that what moms and dads say — or don't say — can have an enormous effect on teens. In other words, parents shouldn't just breathe a sigh of relief over the new decline in smoking rates and think TV ad campaigns have more influence than they do.

The National Youth Tobacco Survey, taken every other year for the federal government, has found significant racial and ethnic differences in the ways that parents deal with smoking. Researchers say that Hispanic parents, even if they smoke themselves, are less likely to allow teens to smoke in the house. The rules appear to have the effect of discouraging teen smoking altogether, not just smoking at home, because Hispanic teens smoke at lower rates than white teens do.

Haley A.'s mother also has established a no-smoking rule at home, but the teen says there has been little discussion of the issue.

"She knows that I know about the consequences," says Haley. Although the teen doesn't particularly want to quit, she says she might be motivated to kick the habit if the penalties were severe enough. "I think if I was grounded every time I got caught smoking or if my phone got taken away, then it would definitely make it harder to keep smoking."

Dos and Don'ts for Parents: Keeping Teens Smoke-Free

These suggestions for parents come from Lyndon Haviland, executive vice president of the American Legacy Foundation (a public health foundation created as part of the 1998 settlement agreement by the states with the tobacco companies):

1. Do take nicotine addiction seriously. "When I talk to parents, I sometimes hear, 'It's only tobacco' or 'They're just experimenting,'" Haviland says. "It's critical to understand that teenagers do become addicted, and it's critical to intervene. For one thing, research shows that cigarettes can be a gateway to use of other drugs and alcohol."
2. Don't assume teens know the dangers. While the latest teen smoking stats are promising, there are still warning signs hidden behind the headlines. The Monitoring the Future study showed that 43 percent of eighth-graders still do not believe that there is a great risk associated with a-pack-a-day smoking.
3. Do talk about (immediate) health consequences and the cost. Teens tend to believe they'll never get pregnant or die in a car crash, so it may be a waste of time to talk about "someday" dying of lung cancer as a result of smoking. Instead, Haviland and other experts advise parents to focus on short-term health and economic effects: "You get a lot of sore throats because you smoke." "If you want to run cross-country next semester, you'll have an easier time if you quit." "Your teeth are starting to get stained." Or focus on the money they're spending: "Gee, you could probably afford your own car if you weren't spending so much on cigarettes!"
4. Don't underestimate your own influence. "We've talked to teens who say, 'If my mom and dad really cared, they'd push me on it,'" Haviland reports.
5. Do talk to your child's healthcare provider, athletic coaches, and guidance counselors. The more caring adults who know your child smokes, the better, Haviland says. "You're surrounding your teen with support for cessation behavior. There is nothing wrong with saying to a soccer coach, 'My daughter will be playing on your team in the fall and I want you to know that she began smoking over the summer.'"
6. Don't turn cigarettes into a "forbidden fruit." No-smoking rules are fine, but only if they are premised on the dangers associated with cigarettes, not just "Those are my rules and you must obey." Make sure you tell your teen how much you admire and respect his or her decision not to smoke, or to quit.
7. Do look for help. The American Lung Association has a comprehensive program for teens called "NOT.," — "Not On Tobacco." Check their website for details at www.lungusa.org. Or visit www.quitnet.com. This site has a calculator to help teens (and adults!) calculate the savings they reap when they kick the habit.


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