Originally published in The Medical Post, VOLUME 38, NO. 19, May 14, 2002

‘Just say no’ won’t work when it comes to talking to your teenager about the dangers of smoking marijuana. Much more will be achieved with rational discussions about responsibility

You walk a fine line at times when responding to teens’ questions. One frequently asked centres around comparisons between marijuana, cigarettes and alcohol. For example, the question might be phrased as: “What is worse, smoking a joint or smoking a cigarette?”

At the outset, I do not condone the use of any drug, illicit or otherwise that compromises public safety, disrupts personal growth and development or interferes with a person’s day-to-day functioning (side-effects of necessary medications notwithstanding).

These questions can be dangerous waters. On one side, there is the parent in you who reaches for the staid paternalistic response: “Are you freaking crazy! What the hell are you thinking about?” This response does not usually win many converts.

The other side is more complex. The message must be clear, imply personal responsibility for actions and decisions, honest, respectful and challenging.

Teens know when you are feeding them a line. They want factual, truthful answers to their questions without moralizing about their actions unless they ask. They know many adults have smoked marijauna, and continue to do so. That message is clear to them. A fresh approach is needed to convey the concerns of disruptive drug use.

They know alcohol and cigarettes cause more death and suffering than all illicit drug use combined. So what is the message? Is one joint more or less harmful than one cigarette?
The smoke from a joint is held within the lungs for a longer period of time than cigarettes. More of the tar and other noxious and carcinogenic compounds settle within the lung. The difference in this case is quantity. Most cigarette smokers smoke more than one or two cigarettes a day, whereas the pot smoker may smoke a joint a day or every other week. Over the long term, cigarettes win this skirmish for physical harm hands down.

However, you do not get high from cigarettes. A joint has more potential for social and personal harm if smoked while driving, operating machinery or engaging in serious interpersonal conflict resolution. Alcohol inebriation produces similar harm.

As with any drug, context for its use is important. Are the pot smoker’s school grades suffering? Are they losing the drive and motivation to pursue their dreams and life goals? Is it thwarting their normal adolescent development? Are interpersonal relationships suffering?

Is there a difference between being drunk and being stoned? Aggression and uninhibited behaviour is more likely with the former state of inebriation. If the person is safe at home, is one drug more unacceptable than the other? If, as a society, we accept the message for responsible alcohol use, what would one say regarding marijuana if used under the same context?

What about other health risks? For the sake of argument, let us assume the dangers of alcohol and cigarettes are already on the table. Marijuana is more potent than it was 20 years ago. There are specific binding sites within the brain for the psycho-active ingredient, THC. There is evidence to suggest memory can be impaired. Daily use can lead to loss of motivation and drive, poor academic performance and delays in adolescent development. A recent study suggested these effects are reversible once smoking ceases. More study is required before accepting this conclusion. The long-term effects are not completely understood.

Quality control of illicit drugs is an issue, as there is none. Users have no idea what they are about to inhale or consume. Is there pesticide residue or is it laced with other noxious substances? Drug dealers are not the pantheon of the Better Business Bureau.

Many parents face these discussions with their children. If they have never smoked pot, then they should say why they did not. One must provide logical adult reasoning. Lectures are ineffective and tend to incite a defensive reaction. They should engage them in thoughtful experiments regarding the consequences of smoking-up.

If parents have a past history of use, I advise them to come clean. Hypocrisy weakens the argument. They should provide reasons why they used it and why they stopped.

Here are some of the questions parents might address:
• Did smoking up make you paranoid?
• Did your appetite cause too much weight gain?
• Are you now embarrassed by the revelations you thought you had about life at that time?
• Are you concerned about its effect upon your memory?
• Did you lose out on potential opportunities for advancement in your professional or social life?
• Why did you stop?
• Did it lose its infatuation value?
• Were there other life endeavours to face?
• Did you replace it with any other drug?

Teens can relate to the reality of these points. It shows them poor decisions are not confined to any one group in society.

Whether parents have smoked up or not, rational discussion does not imply illicit drug use should be condoned. Nor does it mean the rules of the house be compromised. Notions of family honour, respect for oneself and personal responsibility are part of the fabric that serves children well. Setting rational limits for privileges and curfews helps create a balanced system that respects the child’s needs and safety with responsible behaviour. A gradual shift of control from the parent to their child as they demonstrate honourable behaviour reinforces respect and dignity.

Reflecting on our own foolishness of youth and imparting that experience upon teens under the aegis of responsibility and understanding has a better chance of changing behaviour than does confrontation.

Just saying no does nothing.