- Email: [email protected]
Youth Perspectives: Smoking and Health
8 9 10 11 12
airway secretions for bacterial culture. Am Rev Respir Dis 119:337-343, 1979 Kalinske RW, Parker RH, Brandt D, et al: Diagnostic usefulness and safety of transtracheal aspiration. N Engl J Med 276:604-608, 1967 Hahn HH, Beaty HN: Transtracheal aspiration in the evaluation of patients with pneumonia. Ann Intern Med 72:183-187, 1970 Bartlett JG, Rosenblatt JE, Finegold SM: Percutaneous transtracheal aspiration in the diagnosis of anaerobic pulmonary infection. Ann Inter Med 79:535-540, 1973 Bartlett JG: Diagnostic accuracy of transtracheal aspiration bacteriologic studies. Am Rev Respir Dis 115:777-782, 1977. Unger KM, Moser KM: Fatal complication of transtracheal aspiration. Arch Intern Med 132:437-439, 1973
Youth Perspectives: Smoking and Health'
Ourcerned College, in association with 28 other connational organizations, held a confer-
ence in San Francisco, on April 26 and 27, on the subject of teenage smoking. This conference was sponsored by the National Interagency Council on Smoking and Health. Concern over 4,500 new smokers starting each day, knowledge that most all smokers commence before the end of their teen years, and equal frequency of smoking between boys and girls points to the urgent need for fresh ideas to curb this increase in smoking. The message of the first surgeon general's report in 1964, the health statement on all cigarette packages and in all cigarette advertising has not prevented an increase in smoking between 1968 and 1979, from 19 percent to 26 percent among high school girls ages 17 and 18. Youth is entitled to know the healthrelated facts of smoking in the context of general health education. We as health professionals who spend our days assuaging and remedying the bodily ravages that show up after years of cigarette indulgence can well ask ourselves some questions. What have we done to educate patients in health hazards? What instruction do we provide in quit smoking techniques? And above all, where are we working in the field of prevention by education? The conference led by Secretary Califano's keynote speech brought out the fact that cigarette advertising, not peer pressure, is the principal factor encouraging boys and girls to take up the habit. Can youth resist the association so assiduously and photographically contrived: beautiful clothes, fine horses, cars, and swimming pools that portray the
•
EDITORIALS
good life in the most scenic areas of our country ... all while smoking a cigarette? Reports of successful education in nine high school projects across the country, financed and supervised by our national interagency and presented at the conference, brought out the values of teenage counseling by teenagers, the positive imaging of nonsmoking school leaders, the objective demonstration of our own body's physiologic response to smoking, (the study measures skin temperature, pulse rate, tremor control and carbon monoxide level in exhaled breath before and after smoking), and the need for longterm integration of educational, remedial and supportive measures aimed simultaneously at alcohol and drug abuse and, in fact, at all body-abusing habits as well as those related to smoking. Caring for the whole individual is an important element that fosters self-esteem. Strenuous efforts are being made by students and educators and by- the executives of our voluntary health organizations, especially the American Lung Association, the American Medical Association, the American Cancer Society, the American Heart Association and the new office of Smoking and Health in HEW. Attitudes in many schools are shifting in favor of clean air and the nonsmoking student majority often have the "best" common rooms. The dimension of the problem remains large. There are 54 million known smokers in our nation·
3.3 million youths ages 12 to 18 smoke cigarettes; this represents 1.7 million girls and 1.6 million boys who smoke. Since 1968 the percentage of boys 17 and 18 years old who smoke has gone down from 30.2 percent to 19.3 percent, in sharp contrast to the number of girls who smoke. Additionally, and for unclear reasons, women seem to have more difficulty in fulfilling a decision to quit. Perhaps these efforts will soon become apparent in altering the statistical upward swing in smoking popularity, especially among girls. Our role as physicians so far has been small. It could be much greater in counseling teenage patients, their parents and our friends. Perhaps our best role can be the simple example of how we physicians act, our willingness to speak out to patients and say, "Quit smoking," and then to take the time to go on and talk with them on methods for quitting. John L. Pool, M.D., F.C.C.P.· Norwalk, Connecticut o ACCP
Representative to the National Interagency Council on Smoking and Health. Reprint requests: Dr. Pool, 500 Belden Hill Road Wilton Connecticut 06897 ' ,
CHEST, 76: 5, NOVEMBER, 1979
airway secretions for bacterial culture. Am Rev Respir Dis 119:337-343, 1979 Kalinske RW, Parker RH, Brandt D, et al: Diagnostic usefulness and safety of transtracheal aspiration. N Engl J Med 276:604-608, 1967 Hahn HH, Beaty HN: Transtracheal aspiration in the evaluation of patients with pneumonia. Ann Intern Med 72:183-187, 1970 Bartlett JG, Rosenblatt JE, Finegold SM: Percutaneous transtracheal aspiration in the diagnosis of anaerobic pulmonary infection. Ann Inter Med 79:535-540, 1973 Bartlett JG: Diagnostic accuracy of transtracheal aspiration bacteriologic studies. Am Rev Respir Dis 115:777-782, 1977. Unger KM, Moser KM: Fatal complication of transtracheal aspiration. Arch Intern Med 132:437-439, 1973
Youth Perspectives: Smoking and Health'
Ourcerned College, in association with 28 other connational organizations, held a confer-
ence in San Francisco, on April 26 and 27, on the subject of teenage smoking. This conference was sponsored by the National Interagency Council on Smoking and Health. Concern over 4,500 new smokers starting each day, knowledge that most all smokers commence before the end of their teen years, and equal frequency of smoking between boys and girls points to the urgent need for fresh ideas to curb this increase in smoking. The message of the first surgeon general's report in 1964, the health statement on all cigarette packages and in all cigarette advertising has not prevented an increase in smoking between 1968 and 1979, from 19 percent to 26 percent among high school girls ages 17 and 18. Youth is entitled to know the healthrelated facts of smoking in the context of general health education. We as health professionals who spend our days assuaging and remedying the bodily ravages that show up after years of cigarette indulgence can well ask ourselves some questions. What have we done to educate patients in health hazards? What instruction do we provide in quit smoking techniques? And above all, where are we working in the field of prevention by education? The conference led by Secretary Califano's keynote speech brought out the fact that cigarette advertising, not peer pressure, is the principal factor encouraging boys and girls to take up the habit. Can youth resist the association so assiduously and photographically contrived: beautiful clothes, fine horses, cars, and swimming pools that portray the
•
EDITORIALS
good life in the most scenic areas of our country ... all while smoking a cigarette? Reports of successful education in nine high school projects across the country, financed and supervised by our national interagency and presented at the conference, brought out the values of teenage counseling by teenagers, the positive imaging of nonsmoking school leaders, the objective demonstration of our own body's physiologic response to smoking, (the study measures skin temperature, pulse rate, tremor control and carbon monoxide level in exhaled breath before and after smoking), and the need for longterm integration of educational, remedial and supportive measures aimed simultaneously at alcohol and drug abuse and, in fact, at all body-abusing habits as well as those related to smoking. Caring for the whole individual is an important element that fosters self-esteem. Strenuous efforts are being made by students and educators and by- the executives of our voluntary health organizations, especially the American Lung Association, the American Medical Association, the American Cancer Society, the American Heart Association and the new office of Smoking and Health in HEW. Attitudes in many schools are shifting in favor of clean air and the nonsmoking student majority often have the "best" common rooms. The dimension of the problem remains large. There are 54 million known smokers in our nation·
3.3 million youths ages 12 to 18 smoke cigarettes; this represents 1.7 million girls and 1.6 million boys who smoke. Since 1968 the percentage of boys 17 and 18 years old who smoke has gone down from 30.2 percent to 19.3 percent, in sharp contrast to the number of girls who smoke. Additionally, and for unclear reasons, women seem to have more difficulty in fulfilling a decision to quit. Perhaps these efforts will soon become apparent in altering the statistical upward swing in smoking popularity, especially among girls. Our role as physicians so far has been small. It could be much greater in counseling teenage patients, their parents and our friends. Perhaps our best role can be the simple example of how we physicians act, our willingness to speak out to patients and say, "Quit smoking," and then to take the time to go on and talk with them on methods for quitting. John L. Pool, M.D., F.C.C.P.· Norwalk, Connecticut o ACCP
Representative to the National Interagency Council on Smoking and Health. Reprint requests: Dr. Pool, 500 Belden Hill Road Wilton Connecticut 06897 ' ,
CHEST, 76: 5, NOVEMBER, 1979