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Thursday, June 5, 2003 02:20 pm

Why teens still smoke

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"The last cigarette smokers in America were located in a box canyon south of Donner Pass in the High Sierra by two federal tobacco agents in a helicopter who spotted the little smoke puffs just before noon."

--Garrison Keillor, "End of the Trail"

I tell my students that when Garrison Keillor wrote this satire in the early 1980s he could see only the beginnings of a militant smoking opposition. In these parts, smoking sections in restaurants were still a relative novelty. No one talked about the effects of second-hand smoke. When California enacted its bans on public smoking in the 1990s, many bars and restaurants feared they would go out of business. Now those bans are spreading across the country.

Keillor's short story may someday be considered prophetic. But total abstinence will never happen as long as the tobacco industry continues to recruit new smokers among our young people. And the truth is, more teenagers are smoking. According to the American Cancer Society, teen smoking increased by 73 percent between1980 and 1997. Today one in every three teenagers smokes cigarettes.

For extra credit at the end of each semester, I give students an essay exam, asking them to discuss irony. One of the ironic situations on the test concerns the tobacco industry paying for anti-smoking advertisements. Considering the cost of the ads, does big tobacco really intend for these ads to deter smoking? If the ads, which are aimed at 14-year-olds, actually worked, where would the next generation of smokers come from?

Many students choose this topic to write about. As usual they've taught me several things I didn't know.

 

"Young people don't believe it will really harm them that much. Meanwhile their friends, parents, and co-workers smoke. . . . Smoking is everywhere."

--a 17-year-old female from Decatur

On November 20, 1998, the day states announced the settlement of their lawsuit against the tobacco industry, the stock of the leading tobacco companies soared. Investors realized the Big Four tobacco makers would pay only one percent of the damages (at most) directly; the rest would be passed on to smokers through higher prices. Many states immediately figured the settlement money into their budgets. This put them in the position of depending on the continued health of the tobacco industry for their roads, schools, and hospitals.

The tobacco industry can't afford for sales to go down, and now many states are in the same predicament--including Illinois, which not only has diverted tobacco settlement money into an enormously stressed budget but passed a cigarette tax that was the last straw for many adult smokers. Yet teens still buy cigarettes--they've never bought cigarettes for less than two dollars a pack. Teens can't put the new price in the context of the past 20 years the way adult smokers can.

I'm sure most parents would prefer their teens didn't smoke, but do other authority figures back them up? What authority figures do teens hear? Studies show that characters who smoke are common in movies, and they're just as likely to light up in movies aimed at juvenile audiences. In fact, movies with younger stars have 3.6 times as many smoking scenes as films aimed at more mature audiences. And as long as Uma Thurman flirts gorgeously through a haze of cigarette smoke--as long as smoke drifts through all the right nightclubs and bars and hangouts--teenagers will find ways to smoke, no matter how many public service announcements or laws are written to stop them. Most young people know that smoking fills their lungs with toxins like arsenic, cyanide, and formaldehyde. They'll even recite the statistics to you: Smoking kills more than 1,000 people a day in this country alone, and it's far deadlier, in terms of mortality rates, than any hard drug. Then they'll blow smoke into your face.

Maybe when the tobacco industries employ the people who make the Pepsi commercials to do anti-smoking ads--when Brittany Spears tells pre-teens that smoking is stupid--they'll listen. Maybe.

 

"I think the ads have some sort of brain washing scheme. . . . How ironic is it to run an ad campaign against your own product? . . . They know ads won't stop addicted buyers. The ads are another way to boost sales."

--a 19-year-old male from Springfield

"All Smoke High School" ads feature a school where smoking is mandatory for its wheezing, hacking, nicotine-stained students and faculty. The campaign was born in the Illinois Department of Public Health not long after officials learned about the windfall the state would receive as a result of the tobacco settlement. A product of the "I Decide" program, which also put ads on billboards and buses, the ideas for these ads came from teens themselves. Illinois teens skipped the preachy sermons and health warnings and just made fun of the social norm, relying on satire to make their point. "I Decide" spared no expense on production, believing the anti-smoking ads would need to be just as slick as the competing spots for Pepsi and the Gap. The campaign, which started in the fall of 2000, cost almost $4 million in its first year and $15 million in the second. The results surprised the experts. One study by the Department of Public Health showed an 11 percent decline in teen smoking in Winnebago County. But then last August "I Decide" became a victim of Illinois' budget crunch.

Currently, only six states are using the tobacco money to fund smoking-control programs at a level recommended by the U.S. Centers for Disease Control and Prevention. Illinois hasn't been among them. The Department of Public Health has just announced it's heading back to the drawing board, holding a new "teen summit" in Springfield called "Reality Illinois Kicks Ash" on February 16 and 17. Hopefully that's a good sign. We'll see.

 

"The companies are still targeting young and potentially lifelong smokers."

--an 18-year-old male from Mt. Zion

According to the American Cancer Society, young people are the chief source of new customers for the tobacco industry, which each year must replace an increasing number of adults who quit smoking as well as those who die from smoking-related diseases. Nearly all smokers first use tobacco before their high school graduation.

A poll of teen smokers reveals that 95 percent believe they won't be smoking in five years. But smoking is addictive--it's hard to stop. Studies show that the younger someone begins to smoke the more likely he is to become an adult smoker. If you can keep teens from using tobacco when they are adolescents, they'll probably never start smoking.

So when is the right time for a parent to broach the topic of smoking? John Miller, a psychologist and professor emeritus at the University of Illinois at Springfield, notes that parents generally start talking to children about social concerns early. They start with "Don't cross the street" and move on to more complex issues as the child develops an ability to understand. Miller thinks parents need to talk to their children about cigarettes as part of an ongoing discussion about danger, and a child should be ready to comprehend that message between the ages of four and six. "Ads that are aimed at 14-year-olds are too late," Miller says. In fact, he points out, many children start smoking at nine or ten. By the time a child is 14, he's no longer interested in what worries his parents. In truth, anti-smoking ads might be more successful if they starred Big Bird and Barney. "Ads need to be tested for children's reactions," says Miller, "if we really want to reach children."

One of the most frightening times for parents is when their teens go through the "I'm invincible and bad things only happen to other people" stage. This starts at around age16 and ends sometime after the child leaves home. It may be Mother Nature's way of preparing young people to leave the nest.

According to Kathleen Hayward, who teaches adolescent psychology at UIS, this stage can also be called the "Personal Fable" period. "I like to tell my students to look back to ancient Greek mythology," says Hayward. "I recount the story of Icarus, whose father made him wings out of feathers and wax but warned his son not to fly too close to the sun." Icarus, of course, does fly too close to the sun and the wax melts and he perishes. Many times teens don't heed warnings because they don't think the rules of nature apply to them. Bad things only happen to other people. Teens know that people get sick and die--but just other people.

"I feel a lot of smokers started because of peer pressure and the thrill of living on the edge."

--an 18-year-old female from Springfield

According to Hayward, a lot of research says that kids will, in the long run, go along with their parents' values on major issues. Teens are much more influenced by their peers on such matters as fashion and hairstyles. But which set of reasoning applies to smoking?

Peer pressure has a greater impact on teens with self-esteem problems. Miller says kids take up smoking for three reasons: to fit in, to find comfort, and to appear cool and mature. A child with a good sense of self-esteem will be less affected by peer pressure. Building self-esteem starts in the cradle: Parents can teach children that when they feel anxious they don't need a crutch--they can soothe themselves.

The death rate from lung cancer is going down. Miler says this means anti-smoking messages are reaching adults. But kids are taking up smoking at an alarming rate. The drop in lung-cancer deaths has been greater among men. Adolescent girls often start smoking cigarettes to lose weight. Nicotine does suppress the appetite and stimulate the heart, and in our culture thin is valued over healthy. One wonders if adult women have trouble quitting smoking for the same reason their daughters and their granddaughters are taking it up.

"The tobacco industry makes millions and millions of dollars a year. All they care about is keeping people smoking and getting younger and younger kids hooked so they have another generation of smokers ready when this one dies off. . . . Our government just wanted a cut of the tobacco industries millions."

--an 18-year-old male from Mt. Pulaski

The tobacco industry has a long history with anti-smoking ads. In 1966 a young lawyer named John Banzhaff III challenged the Federal Communications Commission's "Fairness Doctrine," which held that when covering controversial topics broadcasters had to give equal time to opposing views. By 1967 broadcasters were airing one anti-smoking ad for every four cigarette ads on prime-time television. The American Cancer Society and the American Lung Association produced most of these anti-smoking ads, and they were so good that the tobacco industry began to panic. According to an article titled "The Truth Is, Anti-Smoking Ads Work," published in the Palm Beach Post, one former tobacco executive told a reporter in 1969 that the companies would "just as soon have cigarette commercials banned if by that they could . . . get the anti-smoking commercials banned, too." When it became clear that smoking rates were indeed dropping, the tobacco chiefs allegedly lobbied to ban cigarette ads from television, much against the will of the broadcasters, who stood to lose hundreds of millions of dollars a year. If industry execs figured that once those anti-smoking ads were gone the decline in smoking would stop, they were right.

 

"I think addiction is all in your head. . . . It is all about self-control and determination."

--a 19-year-old from male Riverton

Young people don't understand that in the beginning an addiction feels like a choice. Only when people try to quit will they realize that the drug was making the choices, not them. According to addiction experts, nicotine has an oil base and is stored in body fat. The addict will crave tobacco for months and sometimes years after the last cigarette.

Julie Plunk, a community outreach counselor who leads the teen program at the Triangle Center in Springfield, agrees most teenagers know that nicotine is addictive. But they see the problems coming when they are much older. Most adolescents can't imagine themselves over 30. Of course, they are seriously addicted long before that.

Many teen smokers whose grades are suffering might be showing signs of addiction to nicotine. The adolescent's body quickly develops a tolerance, and they have to smoke more. They have ritual cigarettes (in the car, after meals, on the phone), and when they can't smoke at the ritual time their body starts to ask for a cigarette. It's normal for a teen to daydream during class--to think about Saturday night, a football game, or a fight with a friend. But when they are so distracted they can't think of anything but a cigarette they may, at best, sweat it out or, at worst, cut the class--either way their mind is not on learning.

Plunk claims that dependency occurs significantly faster in an adolescent than an adult. She says there's a "5-15" rule of progression. In other words, if it takes an adult 5 to 15 years to develop a dependency, a teen will develop the same dependency in 5 to 15 months. In addition, because a teen is still growing and developing, the drug can actually alter the development of the brain and how it regulates dopamine. Because dependency to any drug (especially nicotine) is chronic, the teen is never completely free of the effects of dependency, even if he manages to stop. As with narcotics, dependency on nicotine is progressive. If a person stops smoking for 20 years and then smokes again, they will soon find themselves in worse straits than ever.

"Nicotine is one to the hardest drugs to quit," says Plunk. "For most, nicotine withdrawal is as bad as someone withdrawing from heroin or cocaine." Nicotine is also, along with alcohol and marijuana, one of three "gateway" drugs: if a teen smokes, he's significantly more likely to start using other drugs.

 

"Most kid's first pack is the one they stole from their parents."

--an 18-year-old female from New Berlin

Any psychologist will tell you that children learn to be adults by imitating adults. But children not only imitate their parents--they may inherit a genetic predisposition to nicotine addiction.

The January 1999 issue of Health Psychology carried several studies about genetic predisposition toward cigarette smoking. According to their findings, "nicotine-dependent smokers and smokers with risk factors are different from never smokers, not only behaviorally but biologically." Genetic factors influence when teens start smoking and the number of cigarettes smoked in a day, as well how intensely they smoke. Genetic predispositions also affect a person's ability to quit.

Plunk says the latest studies go back to the old "nature versus nuture" argument--genetic predisposition is powerful. At present it's believed that addictions are 60 percent environmental and 40 percent genetic. People with a genetic predisposition to addictions will undoubtedly become addicted faster, but others can still become addicted by abusing substances over a period of time.


"The tobacco industry is humongous and very powerful, and they do not want people to stop smoking. I think the ads have a hidden meanings."

--a 16-year-old female from Decatur

Like any company, Philip Morris wants a positive public image. It even sponsors an anti-smoking campaign aimed at 10- to 14-year-olds. But a 2002 study by the American Public Health Association found that Philip Morris's ad campaign--"Think. Don't Smoke."-- was really "a wolf in sheep's clothing," increasing the future likelihood of youths smoking.

The ads earnestly encourage teens to resist peer pressure. But the APHA claims that satire is the most effective approach for teens. The ads portray tobacco products as "adult," and therefore cigarettes become "forbidden fruit."

As part of the latest R.J. Reynolds anti-smoking campaign, the company sent out a half a million "We Card" kits to retailers. The premise--that parents should simply tell their children not to smoke--is absurd. A company spokesperson says the campaign even addresses parents who smoke. The APHA claims the message is ultimately a subtler form of marketing--smoking is for adults (or for teens in a hurry to be adults).

The tobacco industry has long pushed age restrictions. According to the Palm Beach Post, Philip Morris gave hefty campaign contributions to officials in states where there were no age limits on tobacco, and these lawmakers subsequently introduced age restrictions. Currently there is a nationwide age law. Data show that when anti-smoking ads began to focus on youths, teen smoking actually increased.

So while we may shake our heads at kids smoking, do we consider what they're up against? Adolescence is a time of rebellion (remember?), but by the time teenagers turn 18 they may discover the drug already has them hooked.

Perhaps we've let big tobacco throw money at a problem they needed to solve. But if the American people gain anything from the tobacco settlement, it should be a healthier future for our children. Instead we're blowing a golden opportunity to cover our own bad checks.

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