TEEN SMOKING CONTINUES TO CLIMB

Despite tales of addiction, 'cool' wins.

Hollywood is once again sending young Americans a pernicious message-
Smoking is OK. It relieves anxiety and tension, breaks the social ice and,
if Holly Hunter is an example, helps a woman maintain a stick-thin figure.
After seeing Hunter's new movie, "Living Out Loud," in which she plays a
chain-smoking divorcee, I had to hold my breath as I plowed through a horde
of cigarette-smoking teenagers gathered outside the theater.

Even as the 34-year decline in the proportion of adults who smoke continues,
youngsters are taking up this addictive habit at an unprecedented rate.
Every day in the United States, more than 3,000 teenagers start smoking.
Since 1991, after a decade of little or no change, cigarette use by high
school students has risen by 32 percent.

These are the young people who will be inflating the smoking statistics -
and resulting illnesses, health care costs and premature deaths - in the
years to come' As a nation with laws and policies that promote clean air and
clean lungs, we are now running backward.

Few young people appreciate how quickly a person can become hooked on
nicotine and how hard it can be to break the addiction. Most youngsters who
start smoking as a means of looking cool and fitting in with their peers
expect they will be able to quit long before it is too late to preserve
their health and protect their future children. Unfortunately, relatively
few who become daily smokers in high school succeed in quitting when they
finally decide to try.

A new national survey former adult smokers commissioned by the Hazelden
Foundation of Minneapolis revealed that former smokers had tried to quit an
average of 10.8 times before succeeding. The process of quitting for good
took an average of 18.6 years, by which time irreparable damage could have
been done to the smokers' bodies and lowered their chances of living out a
normal lifetime.

Current smokers in the survey averaged 3.4 attempts to quit. "These numbers
reflect the serious nature of nicotine addiction," said Carol Falkowski, a
senior research analyst for Hazelden, which runs addiction control programs.
"Nicotine is a powerful drug, just like alcohol or heroi9n, and those who
want to quite often relapse in spite of their good intentions."

Most smokers in the survey said stress was their primary obstacle to
quitting. Others said they enjoyed smoking too much to give it up or that
the craving for cigarettes proved stronger than their will to quit.
Surprisingly, only 5.4 percent of current smokers cited a fear of weight
gain for their failure to quit, although those who run smoking cessation
programs say that weight gain is a major factor among women who fail to quit
smoking.

But even if all adult smokers were able to free themselves of nicotine
addiction, progress in eliminating this health-robbing habit would be
stymied by the millions of youngsters now galloping toward adulthood,
cigarette in hand. A future smoke-free society will depend on keeping
youngsters from starting to smoke in the first place and helping those
already smoking to quit before cigarettes become a permanent part of their
persona.

It may surprise parents to learn, as a recent study of 276 smokers in New
Hampshire high schools indicated, that grades in school and parental level
of education have little or no bearing on the likelihood that a youngster
will become a smoker. Nearly three-fourths of the youngsters had not tried
to quit and 82 percent expected to still be smoking a year later. The
primary goal, then, is to keep kids from starting.

In his helpful little book, "How to Raise Nonsmoking Kids" (Byron Preiss
Multimedia and Pocket Books, 1997,$7.95), Dr. Neil Izenberg, a pediatrician
in Wilmington, Del., advises parents to begin reinforcing the anti-smoking
message very early. He suggests explaining to preschoolers how tobacco
advertising manipulates people into thinking that smoking is cool, socially
acceptable and image enhancing. I played a valuable game with my own sons
when they were young: Uncover the hidden message in advertisements and tell
me how the advertisement is trying to persuade you to buy or use the
product. Later we played a similar game with peer pressure: what were other
people trying to get you to do or believe? Because peer pressure is widely
considered major factor that starts kids smoking, learning how to identify
and resist it is a most valuable asset.

Another helpful tactic is to appeal to youngsters' natural desire for
independence by emphasizing their ability to rise above the influence of
peers and advertising and think for themselves.

Essential to bringing up children who can think and act for themselves is
fostering in them a healthy self-image. Youngsters with a strong sense of
themselves are best able to resist noxious outside influences and more
likely to be leaders, not followers, among their friends. A valuable lesson
I learned from the late Dr. Haim G. Ginott, author of "Between Parent and
Child" (Avon, 1969) is never to criticize the child, only the child's
behavior. Instead of saying "You're a bad boy, good boys don't do things
like that," you should say "What you did is wrong and hurtful."

Fostering involvement in sports, especially competitive sports, is also
helpful, because it easy to convince youngsters that smoking robs muscle
cells of oxygen, interferes with lung function and impairs performance.

And because all smokers smoke for the immediate rewards bestowed by
cigarettes and few youngsters are willing to worry about their health
decades down the line, it helps to emphasize the immediate negative aspects:
a noxious odor that permeates the hair, clothes, skin and breath; stained
teeth; poor physical endurance, and lots of money going up in smoke.

Far less is known about effective stop-smoking techniques for teenagers than
for adults. As you might predict, those who smoke the least, which means
they are less hooked on nicotine, have the easiest time quitting. In other
words, kids should be told that they are most likely to succeed if they quit
while they're behind - in the number of cigarettes they smoke.

Dr. James Sargent and colleagues at Dartmouth Medical School found in their
study of the New Hampshire adolescent smokers that effective quitting was
unrelated to socioeconomic status, school performance, alcohol consumption
or any of several predicted psychological characteristics. The most
important factor was the teen-agers' belief that smoking was not going to be
part of their future. However, the survey also found that most of the
teenagers were not sure whether or not they would be smoking in a year's
time, while only a small percentage thought they definitely would have quit.

Although the study showed that even highly addicted youngsters were
sometimes able to quit, the researchers suggested that success in quitting
may enhanced by nicotine replacement therapy. Youngsters trying to quit
should also be told that withdrawal symptoms are at their worst in the first
three days. And for most people, quitting cold turkey works best.

Checked-by: Don Beck