• Nearly all first use of tobacco occurs before high school graduation. For the most part, people who do not start using tobacco when they are teens never start using it.
• Each day, more than 4,000 teens try their first cigarette, and another 2,000 become regular, daily smokers. Of those, about half will eventually die from a smoking-related disease.
• Cigarette smoking causes significant health problems among children and adolescents, including coughing, shortness of breath, production of phlegm, respiratory illnesses, reduced physical fitness, poorer lung growth and function, and worse health overall.
• The younger you begin to smoke, the more likely you are to be an adult smoker. Young people who start smoking at an earlier age are more likely to develop long-term nicotine addiction than people who start later in life.
• Most young people who smoke regularly are already addicted to nicotine and experience the same addiction as adult smokers. Only 3 out of 100 high school smokers think they will be smoking in 5 years, but in reality, studies show that 60 out of 100 will still be smoking 7 to 9 years later.
• Most teen smokers report that they would like to quit and have made unsuccessful attempts to do so. Those who try to quit smoking report withdrawal symptoms similar to those reported by adults.
• Adolescent tobacco users are more likely to use alcohol and illegal drugs than are nonusers. Cigarette smokers are also more likely to get into fights, carry weapons, attempt suicide, suffer from mental health problems such as depression, and engage in high-risk sexual behaviors.

• Nationwide, about 28% of high school students reported using some type of tobacco (cigarette, cigar, pipe, bidi, kretek/clove, or spit tobacco) on at least 1 of the 30 days before the survey.
• On average, more than 1 out of 5 students (22%) smoked cigarettes. Girls were equally as likely to smoke as boys. White students (25%) were more likely to smoke than black (11%), Hispanic/Latino (22%), or Asian (11%) students.
• About 6% of high school students reported using spit tobacco at least once in the 30 days before the survey. Male students were much more likely to use spit tobacco than female students.
• About 13% of high school students had smoked cigars in the preceding 30 days. Male students (18%) were more likely to smoke cigars than female students (8%).
• Other tobacco use among high school students included pipes (about 3%), bidis (about 3%), and kreteks (about 2%).

Clove Cigarettes (Kreteks)

Clove cigarettes, also called kreteks (“kree-teks”), are a tobacco product with the same health risks as cigarettes. They are imported mainly from Indonesia or other Southeast Asian countries. Kreteks contain 60% to 70% tobacco and 30% to 40% ground cloves, clove oil, and other additives. Kretek smokers have higher risks of asthma and other lung diseases than nonsmokers. Regular kretek smokers have up to 20 times the risk for abnormal lung function. Unfortunately, users often have the mistaken notion that smoking clove cigarettes is a safe alternative to smoking tobacco.

Flavored Cigarettes (Bidis)

Flavored cigarettes, often called "bidis" or "beedies," are imported mainly from India. Their popularity has grown in recent years in part because they come in a variety of candy-like flavors such as chocolate, cherry, and mango, they are usually less expensive than regular cigarettes, and they give the smoker an immediate buzz.
Bidis are hand-rolled in a leaf and tied with strings on the ends. Even though bidis contain less tobacco than regular cigarettes, recent studies have found them to have higher levels of nicotine (the addictive chemical in tobacco) and other harmful substances such as tar and carbon monoxide. And because they are thinner than regular cigarettes, they require about 3 times as many puffs per cigarette. They are also unfiltered. Bidis appear to have all of the same health risks of regular cigarettes, if not more. For example, bidi smokers have higher risks of heart attacks, chronic bronchitis, and some cancers than nonsmokers.

• As a parent, you are the most influential person in your child's decision to avoid tobacco. Tell your kids often about not smoking. Explain the health risks and problems associated with tobacco use; if friends or relatives suffer with or die from tobacco- related illnesses, be honest with your children about the situation. Let them know it strains the heart, damages the lungs, and can cause a whole host of other problems, including cancer. That¡¦s not even mentioning what it can do to appearance: making hair and clothes stink, causing bad breath, dehydrating the skin and staining teeth and fingernails.
• If you use tobacco, you can still make a difference. Your best move, of course, is to try to quit. Meanwhile, don't use tobacco in your children's presence, don't offer it to them, and don't leave it where they can easily get it.
• Start talking about tobacco use when your children are 5 or 6 years old and continue through their high school years. Many kids start using tobacco by age 11, and many are addicted by age 14.
• Know if your kids' friends use tobacco. Talk about ways to refuse tobacco.
• Discuss with kids the false glamorization of tobacco on billboards, and in other media, such as movies, TV, and magazines.

If you are a smoker yourself and don't want your children to start, know that you probably won't have any less influence on your child's decision, and may even have more, because you've been there. You can speak to your child firsthand about:

• how you got started smoking and what you thought about it at the time
• how hard it is to quit
• how it has affected your health
• what it costs you, financially and socially

Convincing your child to avoid tobacco is one of the best things you could possibly do for them. Please forward this newsletter to your friends, acquaintances and family members, so they can show their own children. It’s that important.

Thank you for allowing our team the opportunity to educate you and your family about your health. In this time of Thanksgiving, we are very thankful for you. Next month, you’ll read all about Orthodontic appliances in our Headgear Handbook! See you then!