Tobacco and youth are a mismatch

11 August 2021

Dr Judith Mackay Source: China Daily

Dr Judith Mackay says that governments, NGOs, teachers, parents and social media must do their part to keep children from becoming addicts

Tobacco and Youth are a Mismatch

International Youth Day – August 12

Dr Judith Mackay

Smoking early in life presents serious health dangers to society’s youth

The harm of smoking starts even before conception, as smoking causes infertility in both men and women (as well as impotence in men), so that some children are “missing” — never able to have been conceived. The harm continues in the womb: If a pregnant women smokes, there is increased risk of premature birth, stillbirth and newborn death.

Even after birth, the infant and child born to smoking mothers are more likely to be stunted, risk sudden infant death syndrome (SIDS), poor lung development, exacerbation of asthma, chest infections, acute childhood cancers, cleft palate, possible increased allergies, learning disabilities, and attention deficit or hyperactivity disorders.

If the father smokes during his wife’s pregnancy, and if adults around the infant and child smoke, this affects the child. Worldwide, it is estimated that 40 percent of all children up to age 14 are exposed to secondhand smoke, often within the home.

More recently, research has identified harm to children associated with thirdhand smoke — this is the invisible residue left on surfaces and clothing, cushions and carpeting that lingers long after secondhand smoke has cleared from a room, and which contains many of the same toxic chemicals as secondhand smoke. Toddlers who crawl on the floor are at particular risk.

Smoking starts young. Globally, 25 million boys and 13 million girls between the ages of 13-15 years smoke. A quarter of these began tobacco use before the age of 10. This is the reason why tobacco use among young people has been referred to as a “pediatric disease”.

Cigarette smoking during adolescence and young adulthood begins the damaging processes that lead to cardiovascular disease. The physical harm can be seen even in young smokers who have smoked for less than 10 years.

The reasons children start to smoke include peer pressure, curiosity, rebellion, wanting to look grown-up, thinking smoking is “cool,” and being targeted by the tobacco industry. Girls, in particular, think smoking will keep them slim. Overall, more boys than girls smoke, especially the less-intelligent and less-educated, the lowest socioeconomic class, youth whose parents smoke, and those who earlier experimented with just a single cigarette. Most of these child smokers will continue to smoke into adulthood.

Starting to smoke in childhood and youth also causes a range of immediate health risks. Young smokers’ health and fitness is worse compared with that of nonsmokers.

Not all health problems lie in the future. Youths often underestimate the risks of tobacco and the likelihood of becoming addicted. But symptoms of tobacco dependence commonly start rapidly after the onset of intermittent smoking.

Even during youth itself, there is lung damage, and worsening of asthma and other respiratory problems, and effects on oral health.

Genetic damage occurs early that predisposes to later cancer. The main cancer research organization in the UK recently estimated that every 15 cigarettes smoked will cause a genetic mutation that may lead to cancer. Significant evidence of chromosomal damage is found in teens who smoke compared with those who do not. Teenage male smokers risk sperm damage that can cause subsequent genetic abnormalities in their children.

Cigarette smoking during adolescence and young adulthood begins the damaging processes that lead to cardiovascular disease. The physical harm can be seen even in young smokers who have smoked for less than 10 years.

A new epidemic has hit youth — novel products such as E-cigarettes and heated tobacco products are increasing substantially around the world, bringing their own new health hazards, and with the potential to act as gateway to adult smoking. According to the latest World Health Organization report on the global epidemic, there are about 15,000 flavors of e-cigarettes to lure youth. And young users of E-cigarettes are up to seven times more likely to catch COVID-19.

It is not all bad news. Most of the risks of dying prematurely because of smoking are reversed if people quit smoking before the age of 30.

But — there is an enemy lurking. A major tobacco company itself says, “If our company is to survive and prosper, over the long term we must get our share of the youth market.”

The tobacco industry employs a range of strategies to target and recruit youth.

The more young people are exposed to tobacco marketing, the more likely they are to use tobacco. Whether through more-traditional advertising or indirect promotions and sponsorships, tobacco is falsely linked with glamour, adventure, vitality, social success, health, attractiveness, popularity, slimness, machismo, emancipation, adulthood — all designed to manipulate children into bondage, the opposite of the freedom they promise.

In countries around the world, the tobacco industry has systematically fought against, delayed or watered down measures that have been proved to reduce tobacco use, such as increasing tobacco taxes, implementing smoke-free policies, and banning all forms of tobacco advertising, promotion and sponsorship.

How and when to prevent smoking among youth? The frontal lobes of the brain are the seat of mature judgment and decision-making, and are not fully mature until the early 20s, so it is imperative to prevent smoking during childhood.

Governments should adopt policies as advised by World Health Organization, especially tax policies to make cigarettes unaffordable to youth. Other measures are the creation of smoke-free areas, bans on all forms of tobacco advertising, promotion and sponsorship, mass media campaigns, and plain packaging.

Everyone has a role — not only governments, but non-governmental organizations, teachers, parents and social media. And Big Tobacco must not be allowed to enslave our children.

The author is a senior policy adviser to the World Health Organization, a special adviser to the Global Centre for Good Governance in Tobacco Control, and director of the Asian Consultancy on Tobacco Control.