Cigarette smoking and children
May 21st, 2011
May 18, 2011, 9:04 pm
by Dr. B. J. C. Perera MBBS(Ceylon), DCH(Ceylon), DCH(England), MD(Paediatrics), FRCP(Edinburgh), FRCP(London), FRCPCH(United Kingdom), FSLCPaed, FCCP, FCGP(Sri Lanka) Consultant Paediatrician
* Cigarette smoking has many adverse health effects.
*Every year many children and young people take up to smoking all over the world.
* These young people are lured by various mistaken notions about smoking.
* Parents need to take all steps to prevent their children getting addicted to tobacco .
* Legislative efforts and punitive actions have helped to reduce the general incidence of smoking.
* Public health education too has helped a great deal in prevention of smoking.
The health risks of tobacco are only too well known and extensively publicised. There are long term effects of smoking on many organ systems of the body. Smoking is the leading cause of preventable deaths in the world and it can cause cancer, heart disease, and lung disease. However, children, teenagers and young people get initiated into this habit and continue to smoke. In the United States of America, according to reports from the American Lung Association, each day about 4000 children younger than 18 smoke their first cigarette, and around 1000 of them will become regular smokers. every year in Australia 70,000 teenagers become regular smokers and each day more than 500 Australian school children smoke their first cigarette. Apparently, in Australia more girls than boys smoke regularly. Although we do not have authenticated statistics, it is known that in many countries in Asia, including Sri Lanka, quite a number of young people take up the habit every day.
Scores of children pick up these habits every year and in point of fact, around 90 per cent of all adult smokers started when they were children or teenagers. the position is not too different in other parts of the world and each day, most unfortunately, thousands of children become regular smokers. Hence it is vitally important to ensure that children understand the dangers of tobacco use. Providing information about the risks of smoking to children and establishing clear rules and the reasons for them, can help protect them from these unhealthy habits. Parents also need to know the warning signs of tobacco use and constructive ways to help someone kick the habit. they also have to deal with the many forms of obvious and not-so-obvious forms of advertising that tries to draw young people into smoking.
The differences between subjective feelings of those who smoke and those who do not are shown in behavioural changes that are more apparent in teenagers than in adults. Teens seem to be more abrasive when smoking or they feel like they are older and wiser when they smoke. the fact that teen smoking rates are steadily increasing is certainly most disturbing. Many of them give each other rewards in social aspects such as conversations, companionships and other common social contacts. Research has proven the fact that nicotine has the ability to suppress feelings, suppress appetite for food, is used as stimulation after sex and is thought to be a good way to relax from troubles and feelings of insecurities. Adolescents like to act as if they are someone special or sometimes even dangerous. by smoking they can act on those feelings. Because it is so forbidden it becomes more alluring to them and it becomes almost a challenge. Kids like to get attention and it does not matter if it is good attention or bad attention. they crave for it and by smoking they get big attention. the other teens look at them in all kinds of ways and the adults get upset and do not really know what to do.
One of the major problems with smoking tobacco concerns the chemical nicotine. this compound is an addictive drug. It causes changes in the brain that make people want to use it more and more. In addition, addictive drugs cause unpleasant withdrawal symptoms. the good feelings that result when an addictive drug is present and the bad feelings that one gets when it is absent, make breaking any addiction very difficult. Nicotine addiction has historically been one of the hardest addictions to break. someone can get addicted to nicotine within days of first using it. In fact, the nicotine in tobacco can be as addictive as cocaine or heroin. Nicotine causes a short-term increase in blood pressure, heart rate and the flow of blood from the heart. It also causes the arteries to narrow. the smoke includes carbon monoxide, which reduces the amount of oxygen the blood can carry. this, combined with the nicotine effects, creates an imbalance between the demand for oxygen by the cells and the amount of oxygen the blood can supply. Nicotine affects mood as well as the heart, lungs, stomach, and nervous system. other health risks include short-term effects of smoking such as coughing and throat irritation. Over time, more serious conditions may develop, including increases in heart rate and blood pressure, chronic inflammatory lung diseases. In addition, numerous studies indicate that young smokers are more likely to experiment with other potentially addictive substances like marijuana, cocaine, heroin and other illicit drugs. Nicotine is considered to be the number one entrance drug into other substance abuse problems. Research shows that teenagers between 13 and 17 years of age who smoke daily are more likely to use other drug substances. the use of other drugs is part of the peer pressure that our children have to face. the earlier that our youth begin using tobacco, the more likely they will continue using into adulthood.
Children are twice as likely to be influenced by advertising as they are from peer pressure. they are known to be at least three times more sensitive to advertising than adults. Many countries have banned advertising of tobacco and claim that this alone has reduced by half the number of children who started smoking. Some countries have banned all forms of tobacco industry sponsorships of cultural and sporting events for the same purpose. However there are devious and subtle ways in which the tobacco industry operates to present an alluring picture of cigarette smoking to vulnerable populations. the statutory prohibition of sale of tobacco products to under-age individuals has also helped to prevent young people getting free access to cigarettes.
Children might be drawn to smoking tobacco for any number of reasons. Some of these are to look cool, act older, lose weight, win cool merchandise, seem to be macho and tough or feel independent. But parents can combat those attractions and keep them from trying and getting addicted to tobacco. It is necessary to establish a good foundation of communication with children early on to make it easier to work through tricky issues like tobacco use. Some guidelines for parents to keep in mind are to :-
* discuss sensitive topics in a way that does not make children fear punishment or judgment.
* emphasize why children should be doing the right things rather than the wrong ones. Self-confidence is a child’s best protection against peer pressure.
* encourage them to get involved in activities that prohibit smoking, such as sports.
* show that the parents value the child’s opinions and ideas.
* keep talking to children about the dangers of tobacco use over the years. even the youngest child can understand that smoking is bad for the body.
* ask what they kids find appealing or unappealing about smoking. be a patient listener.
* read, watch TV and go to the movies with the children. Compare media images with what happens in reality.
* discuss ways to respond to peer pressure to smoke. the child may feel confident simply saying "no." But also offer alternative responses such as "It will make my clothes and breath smell bad" or "I hate the way it makes me look."
* encourage and instruct them to walk away from friends who do not respect their reasons for not smoking.
* explain how much smoking governs the daily life of children who start doing it. How do they afford the cigarettes? How do they have money to pay for other things they want? How does it affect their friendships?
If a parent finds out that his or her child has been smoking one should not immediately over-react to the situation. It is certainly not the end of the world. the clothing of the child may smell of tobacco but it is best to ask the child about it. It is quite possible that he or she has been hanging around with friends who smoke or just tried one cigarette. Many children do try a cigarette at one time or another but do not go on to become regular smokers. However, additional signs of established smoking include coughing, throat irritation, hoarseness of voice, bad breath, decreased athletic performance, greater susceptibility to colds, stained teeth and clothing and even shortness of breath
Sometimes even the best of foundations is not enough to stop children from experimenting with tobacco. It may be tempting to get angry, but it is much more productive to focus on communicating with the child. It would be useful to resist lecturing or turning the advice into a sermon. One should try to uncover what appeals to the child about smoking and talk about it honestly. Many a time children are not able to appreciate how their current behaviour can affect their future health. In that sense, one needs to talk about the immediate downsides to smoking such as less money to spend on other pursuits, shortness of breath, bad breath, yellow teeth and smelly clothes. the parents need to stick to the smoking rules that they have set up and under no circumstance should the child be allowed to smoke at home, not even just to keep the peace. Many children say things like "I can quit any time I want", one should ask the child to show it by quitting other things that he or she likes. One should try very hard not to nag. Ultimately, quitting is the child’s decision. Parents could of course help the child to develop a quitting plan and offer information, resources and reinforce the decision to quit with praise. It is a very good idea to stress the natural rewards that come with quitting such as freedom from addiction, improved fitness, better athletic performance and improved appearance. sometimes doctors may be able to help by providing suitable advice and even some treatment plans.
There is a special problem if a parent smokes. Children are quick to observe any contradiction between what their parents say and what they do. Many of them are extremely good at it as well. Despite what anyone might think, most of them would say that the adult whom they most want to be like when they grow up is a parent. However, if a parent is a smoker, there is a significant dilemma in that context but there is still hope to discourage the children. the first step of course, is to admit to that the affected parent made a mistake by starting to smoke and that if that person had it to do all over again, he or she would never start. Second and the most effective one is to quit and kick the habit. It will not be easy or simple. It may take quite a few attempts and may even need extra help of a programme or support group. But the children will be encouraged as they see the parent overcome the addiction to tobacco. they would not want to start on it if they see their parent suffering in their efforts to give it up.
In recent times, there has been a perceptible change in the smoking patterns of the population. the general trend is downwards but children and adolescents taking up to it remains a major problem. There are several reasons for the overall reduction in smoking. These include increasing price of cigarettes, effective efforts and actions taken by schools, legislative prohibition of smoking inside buildings, state and private media campaigns against smoking and intensive health education efforts of the harmful effects of tobacco smoking. the times are changing; what the public and science did not know twenty years ago is now coming to the surface. the fact that smoking cigarettes can cause many health problems is being increasingly recognised and publicised. We are seeing people live longer and healthier lives and the old idea that smoking makes you cool and attractive is perhaps not so obvious now. this is the real truth about cigarettes. they are loaded with harmful chemicals and the end result is that they are a dangerous drug that can seriously harm people.
Note
If our readers need any information on children’s health issues other than those discussed in this column, they are requested to suggest topics that may be of interest to them. the good doctor is willing to write on them.
The writer would appreciate feedback from the readers. Please e-mail him at
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Tags: Adverse Health Effects, ceylon, cigarette smoking, Consultant Paediatrician, Dch, effects of smoking, Fccp, Frcp, habit, Health Risks, health risks of tobacco, Heart Disease, Legislative Efforts, Lung Disease, Mbbs, Mistaken Notions, organ systems, Paediatrics, Perera, Preventable Deaths, Public Health Education, Punitive Actions
