"Well over a dozen studies have shown that kids who watch movies with smoking are more likely to smoke," DiFranza said. "Smoking in movies is more common now than it was in the 1950s and '60s, whereas smoking among adults is half as common now as it was then. Movie producers are not reflecting real life."
Smoking among US teens had been declining steadily from peak levels reached in the mid-1990s through 2004, but the rate of decline decelerated during that period, and in 2005 it halted among eighth graders, the bellwether of smoking trends among teenagers. Today, about 13 percent of teenagers smoke at least once a month.
Studies in rats at Duke University revealed how a single cigarette could keep withdrawal symptoms at bay for far longer than the 12 hours it takes for nicotine to be eliminated from the body. The first dose of nicotine increased production of the neurotransmitter noradrenaline in a part of the brain called the hippocampus for at least 30 days after the nicotine was gone. Another Duke study found an increase in nicotine receptors in the brain the day after the animals got their first dose of nicotine.
NEW STRATEGIES NEEDED
"The take-home message: It only takes a day for the brain to remodel itself in response to one dose of nicotine," DiFranza wrote. "About one-quarter of young people experience a sensation of relaxation the first time they inhale from a cigarette, and this sensation predicts continued smoking."
Further evidence of how easily youngsters become addicted to nicotine comes from studies of quit rates among adolescent smokers. In one typical study, 40 percent of adolescents who tried to quit relapsed in one week or less; only 3 percent remained abstinent a year later.
These findings suggest that new, more forceful strategies are needed to combat smoking by youngsters, which typically leads to a lifetime of smoking. More than 90 percent of adult smokers report that they started smoking as adolescents.
DiFranza maintains that "public health initiatives are most helpful." These include raising the price of cigarettes, a strategy that helped reduce the smoking rate in New York City; a well-enforced nationwide effort to get retailers to stop selling cigarettes to minors; a wider ban on smoking in public places, especially those frequented by teenagers, like restaurants, video game parlors and bowling alleys; mass media campaigns, including broad use by the states of the tobacco industry's payout to sponsor anti-smoking commercials; and pressure on the movie industry to make films smoke-free.
He urged parents, including those who smoke themselves, to emphasize to their children that "it's a huge mistake to start smoking. If they never start, they'll never have to worry about quitting."
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