SUNDAY, Aug. 5, 2001 (HealthDayNews) -- Today's teens have heard from day one that smoking is bad for them.
Unlike their parents and grandparents, they've never seen a TV ad for cigarettes. Chances are, they've never bought candy cigarettes at the corner store. And at school, they've gotten the message year after year that tobacco damages their lungs, reduces their athletic performance, stains their teeth and fingers, and makes their clothes smell -- and their kisses taste -- like smoke.
So why, when the percentage of adult smokers is dropping, is the number of teens who consider themselves regular smokers going up? Researchers who study adolescent smoking say they may have found at least one very grown-up cause for the increase: stress.
"Ten years ago, when kids said they smoked to relieve stress, we saw it as an imitation of adults, that they were just playing at being adults," says Dr. Edwin Fisher.
"Now we realize kids really do have stress, they really do smoke to relieve stress, and we need to take it much more seriously than we used to," adds Fisher, a professor of psychology, medicine and pediatrics at Washington University in St. Louis, who specializes in why people smoke and how they quit.
Each day, nearly 4,800 adolescents smoke their first cigarette; of these, nearly 2,000 will become regular smokers. That's almost two million new teen smokers annually, according to the American Lung Association.
While adults may view the universal worries of adolescence -- dating, getting into college, being accepted by peers -- as minor when compared to the pressures of work, marriage, parenting, or paying the bills, experts say the evidence suggests that teens don't see it that way.
"We're seeing a higher incidence of smoking and tobacco use, marijuana, alcohol and violence," says Dr. Leo Mickey Fenzel, an associate professor of psychology at Loyola College in Baltimore who has done extensive research into adolescent peer pressure, self-esteem and family dynamics. He's also reared four teens of his own.
"We also are seeing a higher incidence of behavior such as girls cutting themselves, which is violence to the self. And eating disorders certainly haven't decreased. Those are some of the clear signs that stress levels are increasing," he says.
Fenzel also points an accusing finger at the media for adding to the insecurity teens inherently feel. Virtually every issue of every magazine geared to teen-age girls focuses on appearance. And girls consistently say in surveys that one of the reasons they start smoking is to manage their weight, he says.
"The media shapes the expectation of what we 'should' be like," Fenzel says. "We've been talking in the literature for 20 years about how these ads tell kids you're not good enough the way you are. You have to have the right clothes, the right make-up, the lip gloss."
Dr. Geri Dino, director of the prevention research center at West Virginia University, has spent years studying teen smoking in her work to design programs to help them quit.
When she has asked teens why they started smoking, the first response invariably is "to relax." If adults are going to help teens quit smoking, they have to help them deal with the stress in their lives, she says.
"You can't just focus on the cessation piece," Dino says. "You have to think about the time period in their lives. Because of the critical life events -- new social roles, dating, preparing for adulthood -- it's a time when people are particularly vulnerable to experiencing stress."
Couple that stress with teens' still-immature coping skills, a society in which about one-in-four adults smoke, and ads that show slim, attractive people enjoying cigarettes with their friends, it's not surprising that 90 percent of smokers start in their teens.
While there's little adults can do to eliminate the stress of adolescence, there are several ways they can help their teens manage the pressure in healthier, more positive ways. The easiest -- and most powerful -- way to help a teen handle stress is to listen to what he or she is saying.
"It's so important to have a close caring adult in every child's life, an adult who makes a teen-ager a top priority, someone who doesn't force his or her will on the teen but knows how to listen," Fenzel says. "The skill of active listening is something we don't really possess in this country. That alone would make a huge difference."
Another valuable strategy for teens is getting involved in a team activity, a religious youth group or service organization.
"It helps them focus on things outside themselves," Fenzel says. "That's so valuable. Generally, if you have a long-term activity, like sports, music, the arts, something with a sense of meaning or purpose in which they can develop skills and feel better about themselves, that's a good way of reducing stress."
What to Do: To learn more about ways to help teens handle the pressures of adolescence, visit Teens and Stress. For information on teen smoking-cessation tips, visit the American Lung Association site.
