Originally published in The Medical Post, VOLUME 38, NO. 3, January 22, 2002

Throw away those old truisms about cigarettes. Here are some new ways to talk to teens about smoking

Our governments spend millions of dollars a year to combat the scourge of teen smoking. Many “hip” public health campaigns have been tried with limited success.

There seems to be no magic formula to tap into the psyche of teens that would reduce the incidence of smoking. The dilemma is that, in our zeal, we may come across as patronizing. Teenagers are in the process of developing their sense of self. They strive for independence, yet conform to their peer group.

The ability to project future consequences is not firmly established in all 15-year-olds. Telling them they will develop heart disease and lung cancer doesn’t cut it. They cannot conceive of these eventsn and ignore the message. If the message is ridiculed by the peer group, the game is over.

What other approaches can be used for this problem? During our classroom visits many students ask about smoking. The questions cover primary health issues to comparative risks between cigarettes and marijuana. Repeating the same old truisms about cigarettes, although factual, does nothing to further the debate.

Fifteen-year-olds tend to be idealistic. Issues such as social justice are seen as black or white, fair or unjust. They want to be independent and to be treated as adults. Using several hypothetical scenarios, we approach smoking from a different angle.

One scenario takes place at 2 a.m.: “You are out of cigarettes. A winter storm rages outside. Do you go to bed or make a dash for the corner store?” We ask the class if they know of any friends who would venture out into the storm. There are always a few nods and hands raised in response.

A discussion ensues about what constitutes reasonable behaviour. Do they think this robs them of their independence? To further emphasize the point we recount an event that occurred in Italy about five years ago. Italy had a dockworkers’ strike that cut off cigarette imports. A cigarette shortage ensued. Smokers from all walks of life were in desperate straits. They began hunting for cigarette butts on the street and yanking the cigarettes out of the mouths of passersby.

We explain independent people would not behave in this manner. Their actions are being directed by their addiction to nicotine. Further, they are paying for the privilege for this loss of independence.

The smokers in the class are asked how they behave if they run out of cigarettes. Do they get irritable? Have difficulty concentrating? Snap at their friends and family? We submit to them the following:
• They are not in control of themselves, the drug is.
• They risk not becoming fully independent. The cigarette companies bank on this and could not be more thankful.
• The cigarette companies benefit at their expense. They have ensnared them, possibly for life, robbing them of their independence, health and money.

Many students have younger siblings. When we ask them, all say the image of their eight-year-old brother or sister smoking is abhorrent. They respond with the same message we give them: That it’s bad for their health. I am always amazed by this compartmentalized thinking.

We bring up reports that cigarette companies have exported millions of dollars of free cigarettes to developing nations. Since the North American market is shrinking, they seek to increase their markets in these countries. Cigarettes ultimately fall into the hands of young children. Addicted, they become lifelong smokers.

Given that the students have already voiced their complete disapproval of childhood smoking, they are now faced with a dilemma. This is a black-and-white issue. Should they continue to smoke, they will be supporting the cigarette companies’ endeavour to find new smokers, usually children in Third World countries. In fact, they will be no better than these companies because they become a contributing member of this system.

They have been presented with a problem requiring an adult decision. Does their sense of social justice overcome their desire to continue smoking? Do they quit smoking and stand up for their principles or partake in hypocrisy? Are they independent enough to follow through on their convictions? Health concerns are not important in this instance. It becomes a moral issue.

We leave them with these thoughts to mull over. This planted seed is effective. They can never erase the images nor run away from their own conscience. They become responsible for their actions with all its social implications.

This information is presented to them at their request. I have outlined our approach in a format that might seem like a lecture in the interest of clarity. However, it is the students who set the agenda. Responding to their questions and concerns creates a more receptive environment. This technique can be applied to many situations. You will have their rapt attention. That is a start.