Dr. Jeff Hersh: No amount of smoking is safe
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Monday, March 19, 2012 | Dr. Jeff Hersh | Categories:
The U.S. Surgeon General recently released their first report on youth smoking since 1994. Although it notes that there has been progress, there is still huge room for improvement. Despite the well-known medical consequences of smoking (and other uses of tobaccos), 1 in 5 adults still smoke. The good news is that this is down from 40 percent of adults in 1965. The bad news is that smoking is still the No. 1 cause of preventable deaths. Cigarettes contain more than 7,000 chemicals and compounds that cause or contribute to many different diseases, including cardiovascular diseases (causing heart attacks and strokes) and 69 different types of cancer (specifically being implicated in 85 percent of all lung cancers). Smoking kills an American every minute of every day, totaling over 400,000 deaths per year, and it costs our healthcare system over 100 billion dollars annually. Just as the negative consequences of smoking are well documented, so are the benefits of stopping smoking. Within a year of quitting, the risk of heart attacks drops substantially. Overall, cancer risks drop by half within five years of smoking cessation. However, it is hard to quit; only 10 percent of smokers who try to quit without any support are successful, although, with help (be it social/psychological support, nicotine replacement medications, prescription medications or other support), almost a third are able to stop. This discussion should make it clear that the best way to address smoking is to prevent people from starting this awful habit in the first place; but what does this have to do with our youth? More than 90 percent of all adult smokers started smoking before age 18, and over 99 percent started before age 26. So smoking prevention can only be effective if it is aimed at our youth; empowered by the Family Smoking Prevention and Tobacco Control Act, which gave the FDA authority to regulate tobacco to prevent use by minors, this has become the present strategy. The good news is that we are seeing the benefits of this approach; the smoking rate for high school seniors is down from almost 40 percent in 1997 to 25 percent today. The bad news is that every day, almost 4,000 minors try their first cigarette, and over 1,000 become daily smokers. This adds up to over 600,000 middle school children and over 3 million high school students being daily smokers. So what becomes of these childhood smokers? About one-third will eventually be able to quit; but one-third of these kids will eventually die of smoking-related disease. Why do kids start smoking? Peer pressure has a big influence; this may come from other kids, but it may also come from “bad examples” (family members and other adults who smoke). It is likely that the $27 million per day ($10 billion per year) that tobacco companies spend on marketing (even though by law this is not allowed to target minors), and the almost 50 percent of PG-13 rated movies that show someone smoking, are also contributing factors. Kids often try smoking “to see how it feels”, thinking it will be easy for them to stop at any time. However, for the 75 percent of daily smoking kids who want to stop, the quitting success rate is as low as it is for adults. Since so many kids try their first cigarette at young ages, educating children about the negative effects of smoking must begin at very young ages. By age 5, parents should already have started talking to their child about not smoking. Health care providers should begin to address this issue during routine well-patient checkups and school programs should be initiated by this age as well. Talking is not enough. Parents who smoke should consider their children’s health as the ultimate motivation for them to stop, both to prevent secondhand smoke exposure as well as to set the right example; we all know “do what I say, not what I do” is not an effective parenting strategy. Kids need to understand that there is no safe amount of smoking. Parents should be aware that kids who engage in other high-risk behaviors (illegal drugs, alcohol, unsafe sex or other risky behaviors) are at an increased risk to start smoking. We have come a long way since the mid-’90s, but our work is not yet done; every year hundreds of thousands of Americans still die from smoking-related illnesses, and hundreds of thousands of teens become daily smokers. Jeff Hersh, Ph.D., M.D., can be reached at DrHersh@juno.com.The Leader