MARY KATHARINE MARONEY
Special to the Observer-Dispatch

Although most kids don’t smoke, an alarming number of children and adolescents do smoke cigarettes or use smokeless tobacco.

In 1994, the surgeon general of the U.S. Public Health Service identified smoking as a pediatric epidemic. In 1997, the Centers for Disease Control and Prevention conducted a survey and reported that the prevalence of cigarette smoking among U.S. high school students increased from 27.5 percent in 1991 to 36.4 percent in 1997.

Although smoking among adults has decreased, smoking among youths continues to show an upward trend, with the average teen smoker starting by age 14 — long before the age when they can legally purchase tobacco products.

An increasingly popular substitute for cigarettes that poses serious health hazards is smokeless tobacco snuff and chewing tobacco.

Many athletes — particularly baseball players — who are admired by children and adolescents use this form of tobacco.

Thought by some to be less hazardous than cigarettes, smokeless tobacco has been shown to cause cancer of the lip and mouth, periodontal disease, tooth erosion and other oral lesions — not to mention foul-smelling breath and tooth staining.

There also is convincing evidence that smokeless tobacco can be just as habit-forming as cigarette tobacco. Research also has shown a strong correlation between the use of smokeless tobacco and eventual cigarette smoking.

The health hazards of smoking at any age are undisputed. It is well-documented that cigarette smoking leads to cancer, heart and lung diseases.

Smoking-prevention programs for youth that focus on negative long-term effects of smoking on health have not been effective, however.

For children and adolescents who are more concerned with the “here and now” than future health consequences, peer pressure and the advertising images of being cool, sexy or successful increase their vulnerability to begin smoking.

Of particular concern are reports from several studies that show that leading cigarette and smokeless tobacco companies have increased both the amount and type of advertising in youth-oriented magazines — such as Rolling Stone and Sports Illustrated — since promising in the 1998 state tobacco settlement not to “take any action, directly or indirectly, to target youth.”

For example, advertising for the Skoal brand of products includes a photo of a jet skier along with the headline “A Splash Bolder.”

One series of ads for the Rooster brand of smokeless tobacco features such headlines as “Birds of a Feather Party Together.”

There can be little doubt that kids — who are twice as likely as adults to remember tobacco advertising — are the target of such advertising.

In addressing this problem, there are many resources available to parents, teachers and health-care providers that offer prevention strategies and smoking-cessation strategies.

The American Nurses Association has published a position statement on prevention of tobacco use in youth that may be found on the www.con.ohio-state.edu/tobacco Web site, along with additional information from the Ohio State Nursing Center for Tobacco Intervention.

Research has shown that children and teenagers least likely to smoke are those whose friends and family don’t smoke, those interested in academics or athletics, and those who plan to go to college.

In discussing tobacco use with kids, it may be useful to provide the following information:

E There are alternatives to smoking to be “cool, sexy, successful and sophisticated.”

E Not smoking demonstrates independence and nonconformity, traits usually admired by youth.

E Cigarette smoking causes foul-smelling hair, clothes, breath, detracts from physical appearance and actually decreases athletic performance.

E Although many adult smokers once believed in the social benefits of smoking, by far the vast majority state they would now quit smoking “if they could.”

E There is increasing evidence that secondhand smoke is a serious health hazard to nonsmokers who are regularly exposed, particularly babies and children.

E Tobacco is expensive. It not only takes your money but also is harmful to your health.

If we believe that children are our future, we must share in the responsibility to make that a reality by playing a constructive role in reducing tobacco use among our youth.

Mary Katharine Maroney, Ph.D., R.N., is director and associate professor of nursing at Utica College. She can be reached via e-mail at: mmaroney@utica.edu.