TUESDAY, Dec. 6, 2016 -- Cigarettes are one accessory today's California teens are more than willing to forego, a new survey finds.
Fewer of them than ever think cigarettes are cool, the study found, and many view smoking as riskier and less socially acceptable than they did about a decade ago.
This finding mirrors what's happening across the nation, where cigarette smoking among teens has declined greatly over the past two decades. The drop is largely the result of smoke-free policies and public health campaigns that highlighted the harms of smoking, the researchers said.
That's the good news. On the flip side, teens are turning to e-cigarettes, hookahs, cigars and chewing tobacco to get their nicotine fix, according to the authors of a new study.
"Adolescents are still not aware of the addictive properties of nicotine," said lead researcher Bonnie Halpern-Felsher. She's a professor of pediatrics in the division of adolescent medicine at Stanford University School of Medicine in California.
Nicotine is more addictive to the developing brain, Halpern-Felsher said. "Because of how nicotine affects the brain, teens are more likely to become addicted than [other people] and have a harder time quitting," she said.
The change in attitudes toward cigarettes is largely due to aggressive tobacco control efforts and health messaging "that have changed the perceptual landscape around cigarettes," Halpern-Felsher said.
"We need to pay more attention to the addictive properties of all tobacco products. We need to talk about nicotine and not just cigarettes," she explained.
"We need to apply the same messages we had about cigarettes to e-cigarettes and other products, and the [U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention] should be focusing more messages on addiction and short-term health risks of these products," Halpern-Felsher suggested.
In two surveys -- one in 2001 and the other in 2015 -- the researchers collected data from a total of nearly 700 California high school students to see how attitudes toward smoking had changed over the years.
The results showed a decrease in the number of teens that plan to smoke or think smoking makes them look mature, while more teens believe that smoking is likely to cause health problems, Halpern-Felsher said.
Looking at two surveys that contained nearly the same measures of cigarette-smoking perceptions, intentions and use, the researchers found:
- In 2015, 94 percent of teens said they did not intend to smoke, compared with 65 percent in 2001.
- Fewer teens in 2015 said they had smoked cigarettes (5 percent of girls, 6 percent of boys) compared with 2001 (25 percent of girls and 28 percent of boys).
- In 2015, 17 percent of teens said that smoking made them look more mature, compared with 28 percent in 2001.
- More teens said "smoking could land them in trouble" in 2015 (86 percent) than in 2001 (77 percent).
- In 2015, 76 percent of teens said smoking could lead to a heart attack, and 85 percent said smoking could cause lung cancer, compared with 69 percent and 78 percent, respectively, in 2001.
In addition, the 2015 data showed that an increasing number of California teens felt they would be less likely to be able to quit smoking whenever they wanted or to experience short-term benefits, the researchers found.
Because both studies were done in California, the results might not apply throughout the United States or abroad, Halpern-Felsher said. Other studies have shown that teens have favorable attitudes about e-cigarettes and are increasingly using them, and may be more likely to smoke cigarettes as a result, she added.
One expert agrees that the message to teens needs to expand to include all nicotine delivery devices, including e-cigarettes and hookahs.
"E-cigarettes are perceived by kids as harmless, which is a real problem and has been doubling every year," said Stanton Glantz. He is a professor of tobacco control at the University of California, San Francisco. "Kids don't understand how dangerous they are," he added.
And, Glantz said, e-cigarettes are a gateway to tobacco use. "Hookah use is also increasing. We are having increasing amounts of teens using several tobacco products at the same time," he noted.
"Kids need to learn more about addiction, and that when they start using these products they are losing control of their body," Glantz suggested. "This is an important message that needs to be better communicated."
The report was published Dec. 6 in the Journal of Adolescent Health.
For more about tobacco, visit the U.S. Centers for Disease Control and Prevention.
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