Introduction

Puberty is the time when young adolescents consistently want to try out something new and they want to be super-cool in their groups. This is the time when they have high self-esteem, are egoistic and are self-centred. They have attention seeking behaviours and they want to be among those friends and peers where they are either praised or followed. To gain this attention they do and try out different things. They try out latest fashions even if it is weird, they ride fast bikes and cars and sometimes they even try out drugs, smoke and weed.

Adolescence is the time of intricate interaction between physical and psychosocial development. This is also the time when environmental and social attitudes also have an impact on the behavioural attitude of the teenagers. Sometimes social or cultural taboos related to use of marijuana, tobacco or alcohol may promote or demote its use in teenagers.

Why do youngsters smoke?

There are many reasons for which youngsters try out smoking. The reasons can be many from exposure to smokers (friends, parents), availability of tobacco, low socioeconomic status, poor school performance, low self-esteem, lack of perceived risk of use, and lack of skills to resist influences to tobacco use. Teenagers are not from different world as they smoke for the same reasons as adults. Let’s have a look over these factors one by one.

• The first and most important cause that can be attributed to teenagers smoking is the presence of a family member who is an active smoker. Kids often try to imitate parents or close relatives. They do what they learn from their surroundings.
• Kids especially teenagers do all the things that their peers are doing. Peer influence is maximum in this age and if the friends or the peer group actively smokes chances are there that the individual will smoke.
• Teenagers also want a continuous thrill in their life. So teenagers do smoke to break this boredom and try out something new.
• Teenagers believe what their peers say and many teenagers have admitted that they smoke to overcome stress.
• Smoking in girls has often been associated with weight consciousness and weight control mechanism. Girls are too conscious about their body image at this time and smoking is associated with loss of appetite and weight loss.
• Poor personal relationships and lack of love and affection at home also compels youngsters to try smoking.
• Seeing movie stars or their favourite sportsperson advertising motivates kids to smoke as they blindly follow their role models.

What causes addiction of smoking?

It is usually seen that if a person starts smoking once it becomes difficult for him to quit smoking. Have you ever thought that is it just a psychological thing or the cigarette itself has an addictive effect?

The addiction of smoking is caused by nicotine- the principal ingredient present in cigarettes. Nicotine is the primary active ingredient in cigarettes and it is addictive. The addiction of cigarette smoking can be attributed to the fact that nicotine is absorbed by multiple sites in the body including lungs, skin, gastrointestinal tract, and buccal and nasal mucosa. These sites are highly permeable and absorb nicotine. Nicotine causes an effect on acetylcholine receptors by causing an increase level of dopamine hormones which is a feel good hormone.

So the person smoking feels relaxed and this gives a motivation for smoking. Nicotine also causes an elevation in the blood pressure, respiration and heart rate due to the effect of nicotine on adrenal glands which causes release of epinephrine. The average nicotine content of 1 cigarette is 10 mg and the average nicotine intake per cigarette ranges from 1.0 to 3 mg. Nicotine can be detected in urine, serum and saliva for about 19-24 hours due to its metabolic product cotinine. Sometime it forms a strong basis in medico legal evidences.

Health effects of smoking

All of us know that smoking has deleterious effect on our health but still we continue to smoke. It is due to the fact that we become ignorant and think that nothing bad can actually happen to us. Once we become aware of the fact that what all effects we can have on our health most of us will surely want to quit smoking. Let us have a look over the possible health effects of smoking one by one:

• The first and foremost effect of smoking is seen on the respiratory tract. It causes chronic cough along with sputum production and wheezing.
• Smoking also has carcinogenic elements and hence increases the risk of cancer.
• Smoking also has an effect on your skin and small brown spots can be seen on the skin.
• Tobacco smoke also induces hepatic enzymes which interfere with the metabolism of certain drugs like phenacetin, theophylline and imipramine.
• Smoking if done in pregnant females give rise to low birth weight babies, premature deliveries and stillbirths in some instances.

So these are just to name a few. Other effects that smoking has on our personal or social life are just unaccountable. If a person tries to quit smoking all of a sudden, withdrawal symptoms can occur. Irritability, decreased concentration, increased appetite and strong cravings for tobacco are common withdrawal symptoms.

Treatment

If you have thought about quitting smoking you need to be highly motivated. You can try out following things:

• Your friends might make fun of you or might not consider you as a part of the group but after all it’s your life and you are the only responsible for what you are doing.
• You can join any support group which helps teenagers quit smoking. You should also engage in sports activity that gives you the required rush of adrenaline to what you are used to.
• Keep your hands and mouth busy. Have some snacks or chewing gums or some candies to nibble when you feel the urge to smoke.
• The approach to smoking cessation in adolescents includes the 5 A's (Ask, Advise, Assess, Assist and Arrange) and use of nicotine replacement therapy in addicted teens who are motivated to quit and are not using smokeless tobacco (SLT).

References

1. Nelson textbook of paediatrics, 19th edition, Kliegman, Stanton, St. Geme, Schor, Behrman. Elsevier publication. ISBN: 978-1-4377-0755-7. Chapter- 108
2. Current Pediatric Therapy, 18th edition, Frederic et al, ISBN-13: 978-0-7216-0549-4. Chapter-6