Newspaper article St Louis Post-Dispatch (MO)

Teens and Tobacco: Don't Blow Smoke

Newspaper article St Louis Post-Dispatch (MO)

Teens and Tobacco: Don't Blow Smoke

Article excerpt

DOCTORS, of course, are always urging their patients to stop smoking.

But one doctor, Bradley Schlagger, thinks that the internists, cardiologists and lung specialists who do most of the talking are missing a key audience.

After all, they are mostly addressing adults; the focus is on getting smokers to quit.

Schlagger thinks the focus should be on never starting to smoke in the first place.

He thinks it's time for pediatricians to play an aggressive part in the anti-smoking campaign.

Parents need to join the effort, too.

"Smoking is a pediatric problem," says Schlagger, a resident in pediatric neurology at St. Louis Children's Hospital. "Between 80 and 90 percent of smokers start before they are 18. Over half start before they are 14."

Nor, he adds, are those numbers changing much. Smokers are quitting in significant numbers; in 1977, he said, about 40 percent of Americans smoked cigarettes, but for several years now that number has dropped and held steady at about 25 percent.

Why, however, doesn't that number keep dropping? Why the plateau? According to Schlagger, the reason is new smokers - and most new smokers are teens.

To change that, both pediatricians and parents have an obligation to keep kids from taking up the habit, Schlagger says. But, he acknowledges, it's tough. While it is possible that one day, a seventh or eighth grader may say "I've been wondering about cigarettes and would like to know what you think," as a rule pediatricians and parents both need to be more aggr essive in bringing up the topic, potentially awkward as it is.

Even the doctor or parent who is willing to try may find it as hard to talk about smoking as it is to talk about sexually transmitted disease or pregnancy. What on earth do you say?

According to Schlagger, the first thing to know is what not to say: "Don't smoke. Period."

"That is not going to impress an adolescent," says Schlagger, who, in his crusade to keep kids from smoking, has these conversations as often as he can. "A just-say-no approach is insufficient; teens don't think anything bad is going to happen to them. Invulnerability is a hallmark of adolescent self-image.

"So, you need to delve into their feelings and make a connection. There is no one right thing to say."

That means taking the trouble to know the teen you're talking to well enough to have some sense of how to make your message hit home. It also means being flexible enough to try out different approaches if you sense that you're not getting through.

Schlagger offers some suggestions of approaches worth trying:

The numbers game. Pediatricians and parents need to be conversant with statistics regarding smoking so that they can sound informed, not just dictatorial, when they're making the case against cigarettes. Here are some of Schlagger's favorites:

About 500,000 Americans die every year from smoking-related diseases - that's about 20 to 25 percent of all American deaths. …

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