This month I would like to discuss one of my favorite topics: smoking. I know this is parenting magazine and the discussion should center around children and family health. What if I were to say smoking is a childhood disease with adult manifestations and it affects the whole family? Then it would pertain to this magazine.

The average age children begin to smoke is about 12 years old. In some states, nine years old is the average. It does not take long for a person to be addicted to nicotine in the cigarettes. Unfortunately, nicotine is naturally found in our brain as a neurotransmitter. Within our brain are nicotine receptors which, when stimulated, release dopamine (another neurotransmitter) into the mesolimbic area of the brain giving the person a calming or stimulating effect. Once additional nicotine is introduced from smoking, nicotine receptors within our brain expand and clamor for more nicotine soon establishing an addiction. To date, nicotine appears to be the most addictive substance known (including cocaine). Although nicotine is the addictive substance in cigarette smoke, nicotine itself causes relatively few health risks.

Within cigarette smoke over 60 carcinogens and over 200 toxins are found! This bad stuff includes ammonia, arsenic, cadmium, carbon monoxide, formaldehyde, hydrogen cyanide and toluene. The top four causes of death in the United States are related to cigarette smoking: coronary heart disease, strokes, cancer, and COPD (emphysema, asthma and chronic bronchitis). In fact, a lifelong smoking woman will have a shorter life by 14 years (12 years for a man). I think almost everyone agrees that cigarette smoking is linked to lung cancer (about 90% of the risk of lung cancer is due to cigarette smoking), but did you know that smoking is related to oral cavity/pharyngeal, laryngeal, esophageal pancreatic, kidney, bladder, cervical cancer and leukemia? Smoking is also related to adverse surgical outcomes, increased risk of hip fractures, osteoporosis, peptic ulcer disease, decreased fertility rates and pregnancy complications.

If the above all pertains to the individual smoker, what about the smoker's family?
Second hand smoke risks are real and include increased risk of sudden infant death syndrom (SIDS), increased risk of asthma and poorly controlled asthma, increased risk of childhood middle ear infections, increased risk of childhood respiratory infections and also lung cancer.

The best way to prevent all of these dreadful complications of smoking is never to start. It's very important to talk to children about not smoking. Most young children find cigarette smoke irritating and tend to be fairly receptive to the idea smoking is bad for you. Teenagers may be a different story. Smoking is still seen in the movies and may be perceived as "cool" so that may be a reason for trying cigarettes. It may take very few cigarettes to become addicted for life.... Discussing smoking with teenagers has been found to be helpful; therefore, I would encourage it.

If someone is a smoker, it is beneficial to try to stop. Stopping smoking requires two elements: behavior modification and medication intervention to improve success. Behavior modification requires changes in habits. Start small, by for example, not smoking when having morning coffee. Medication intervention includes nicotine replacement therapies, Wellbutrin (Zyban) and Varenicline (Chantix). The latter is a new medication with the best success to date.

Remember, it's important to realize that it is a and then stop this pediatric disease.