More than 50 years after the Surgeon General said
smoking can cause lung cancer, cigarettes have been banned from
television commercials, workplaces, billboards, restaurants and bars.
But plenty of them are still winding up in the hands of teenagers and
young adults.
The use of tobacco is a
"pediatric epidemic" nationally and abroad, according to a report the
Surgeon General's office released in March. The report found that after
years of steady drops, declines in cigarette use by youth and young
adults have slowed; for smokeless tobacco products, the declines have
stalled.
"I am still surprised by how many people smoke,
and even more surprised by how many young people still smoke," said Dr.
John Podkowa, a general internist with Southcoast Physicians Group, who
contrasted today's new smokers with people who started smoking before
the health dangers were clear.
Kayla Jones, 21, has already been smoking on and off for nine years after picking up the habit with friends.
"I like the sensation," she said, while smoking in downtown New Bedford. "I can quit whenever I want."
Kevin
Nunes, 28, didn't start smoking until he was 20. But by the time he
quit about a year and a half ago, he'd hit about two packs a day.
As a valet at Cork Wine and Tapas in New Bedford, Nunes sees plenty of people of all ages leaving downtown bars to light up.
"It
doesn't necessarily even have to be downtown," he said. "You could just
be passing through Rockdale Ave., where kids are commuting home from
school. ... They're smoking."
Massachusetts
Department of Public Health statistics show progress curbing the trend
in recent years, with the rate of smoking among young adults (18-24)
dropping from 29.3 percent in 1999 to 20.6 from 2008-10. These latter
figures, however, were higher than the state's smoking rate for adults
of all ages, which was 15 percent.
"Obviously
this is a concern to us and we do know that the tobacco industry markets
to both youth and young adults," said Lois Keithly, director of the
Massachusetts Tobacco Cessation and Prevention Program.
Key
in this targeted marketing are single-sale cigars in shiny packaging
that appeals to youth, flavors that please their palates and prices that
are within their budgets, according to Keithly.
"They're
becoming ubiquitous and we know from youth surveys that they are
increasingly smoking these," she said. The CDC also pointed to the
emergence of "spitless" tobacco products that teens can use undetected.
Most
smokers begin when they're too young to comprehend how it can affect
their health, Keithly said. And though smoking has broadly fallen out of
social favor, she said it's still often considered cool in young
circles.
From the dorms of UMass Dartmouth to SouthCoast hospital campuses, there are fewer and fewer places where smokers can light up.
But a major risk factor remains in an environment regulators haven't touched: The home.
"Current
parent smoking is certainly a big risk factor," according to Dartmouth
resident Richard Rende, a research professor in psychiatry at Brown
University's medical school and the head of a research division at
Butler Hospital in Providence. In collaboration with others, Rende has
conducted grant-funded research on the topic and said smoking by an
older sibling represents another risk.
Beyond
influencing a child's choices and access to cigarettes, family affects
whether he or she has the genetic predisposition to become addicted, he
said.
Meanwhile, Dr. Podkowa said he thinks many smokers still don't realize just how bad smoking really is.
Most
people associate smoking with lung cancer or emphysema, while failing
to appreciate that smoking dramatically increases one's risk for heart
disease, he explained. He said smoking also significantly boosts one's
risks for a slew of other cancers ranging from head and neck and throat
cancers to breast and bladder cancer.
Dr.
Podkowa's patients often see him in the hopes of preventing future
health problems, and he said young patients sometimes worry about their
cholesterol levels.
"I really tell them there
is literally nothing as a primary care doctor I can do for them that's
better for them than quitting smoking," Podkowa said. "Worrying about
your cholesterol while you're still smoking is like having an oil tanker
spilling oil off the beach and you're worried about dropping something
in the ocean."
