Surgeon General: Scary Information on Kids and Smoking

Teen smoking - a timebombLast month marked the 50th anniversary of the first Surgeon General’s report on the health effects of smoking. In 1964, this report was the first to definitively link smoking to lung cancer. Back then – if you’re old enough to remember, or you watch Mad Men – people smoked everywhere…in offices, restaurants, hospitals and airplanes. No one spoke about smoking as a cause of cancer, heart disease or emphysema. No one had heard of COPD or secondhand smoke.

Fifty years later we know much more. And with last month’s release of the 32nd Surgeon General’s report on the issue, we have learned that smoking causes even more diseases than previously thought, including 13 cancers, diabetes, rheumatoid arthritis, macular degeneration, erectile dysfunction, ectopic pregnancies, and impaired immune function. The effects of exposure to cigarette smoke on children and fetuses are also dire, including cleft palates and possibly other birth defects, impacts on brain development, respiratory illnesses and sudden infant death syndrome (SIDS). Earlier Surgeon General Reports have emphasized that smoking affects nearly every organ and system in the body, which is confirmed by this new information.

My family provides a classic case study on the devastating effects of smoking. I was a baby in the 1960s and – although I have never smoked – I grew up with parents and relatives who smoked frequently and heavily, and I know they wish they had known the effects of smoking much earlier. My parents have expressed their regret for the health effects I have experienced that could very likely have been due to exposure to cigarette smoke. At less than one year of age I was in the hospital in an oxygen tent in the hospital with pneumonia, and had frequent bouts of bronchitis throughout childhood – continuing with more than the usual number of colds and infections as an adult. I also have allergies, which could have come partly from smoking’s effects on the immune system. And I have experienced an ectopic pregnancy. My father has had serious heart disease, resulting in triple-bypass surgery and now has diabetes. My mother has already lost 2 siblings to lung cancer (both current or former smokers), including one of my favorite aunts just last year.

While smoking rates have dropped significantly over the past 50 years, from 45% to 18%, we still have 42 million smokers in the US, including 3 million children – most of whom will die prematurely due to cigarettes. The release of this new report is a good opportunity to look at the issue of smoking in society and identify what we can all do to eradicate this country’s number one preventable cause of disease and death.

First we must look to our kids.

According to the National Cancer Institute, 90% of smokers try their first cigarette before age 18 and virtually all by age 26. Almost no one starts smoking after age 25. Unfortunately, about one-quarter of our high school students have smoked in the past month – a higher smoking rate than among adults. And according to a 2012 Surgeon General’s Report, in recent years the long-term decline in use of tobacco by our youth has slowed or even stalled completely in some cases. This matters because youth are not small adults: the younger they start smoking the more susceptible they are to the addiction of nicotine. Plus teens are still developing their lungs and those who smoke may end up as adults with lungs that will never grow to full size. Additionally, early cardiovascular damage is seen in most young smokers. Here are some actions parents can take to help their kids avoid smoking.

  • Stop teen smoking before it startsWhether or not you smoke, be an anti-smoking role model. If you smoke, try to quit, as kids are more likely to smoke if their parents do. But check out this Tobacco-free Kids fact sheet for other things you can do to set a good example whether or not you smoke
  • Ensure your child has access to good, engaging anti-tobacco education. Many schools and community health centers already provide proven programs. In Indianapolis we have a wonderful facility, the Ruth Lilly Health Education Center, which provides evidence-based smoking and other health education programs using engaging technology such as audience response, “smell-a-vision” and TAM, a “transparent anatomical manikin”, which demonstrates health impacts on the body.
  • Appeal to their priorities. Kids won’t really care that smoking increases risk for long-term chronic diseases, but boys might care that it contributes to erectile dysfunction (some doctors use this argument with young men) and girls might care that people who smoke are not thinner than non-smokers. They may also be persuaded against smoking if they understand how much faster it ages your face. Check out this New York Times article about a very interesting study assessing the difference in facial aging of adult twins with different smoking habits.
  • Know your child’s friends. Peer pressure is a big reason for starting smoking.
  • Try to limit your child’s exposure to smoking in movies and other media. There is strong data from studies that smoking in movies makes kids more likely to smoke. Those with the highest exposure to smoking images are twice as likely to smoke as those who have the least exposure. Yet, according to the Surgeon General, “in 2010 nearly a third of top-grossing movies produced for children—those with ratings of G, PG, or PG-13— contained images of smoking”. Even Disney has smoking in kids’ movies! To learn more about smoking in movies and what you can do check out the advocacy website, Smoke Free Movies.

Support Community-wide Anti-Smoking Policies

Smoking bans and other anti-tobacco policies have proven extraordinarily successful at reducing the access to tobacco and rates of use across all ages. Here are some of the proven strategies, supported by the Surgeon General, US Centers for Disease Control and Prevention (CDC) and the World Health Organization.

  • Anti-tobacco mass media campaigns.
  • Higher tobacco prices, including tax increases. Higher prices are particularly effective with young smokers who are more sensitive to the cost of cigarettes.
  • Restrictions on youth advertising and access to tobacco.
  • Smoke-free policies for public spaces and workplaces.

All people concerned about the impact of smoking on our youth and society can help advocate for better anti-smoking laws and policies by supporting organizations that work to establish these regulations through donation or volunteering – and by making your concerns known to elected representatives, policymakers, and local community leaders. We can also applaud the actions of businesses like CVS, who announced this week that they will stop selling tobacco products, as this is inconsistent with their strategy to be seen as a broad healthcare company – and send a message to others who have not yet made this move.


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