October 10, 2000
Volume XXXIII, No. 35



HSC Profile

In Memoriam

Newly Granted


Teen coalition isn't just sending up smoke signals

It heightens awareness, lowers anxiety levels, opens or widens the brain’s blood vessels, relieves pain and increases endorphins that enhance the processes involved in thinking and knowing.

But it also can cause digestive problems (such as upset stomach, cramping and constipation), low body temperature, vomiting, constricted blood vessels and high blood pressure in some people, increasing the potential for aneurysms, seizures and respiratory distress, not to mention a variety of breathing problems.

It’s contradictory. While it simultaneously calms nerves, it speeds up the heartbeat. But mostly, nicotine—smoking—is associated with causing cancer. Teens are taking to tobacco too much, said a Health Science Center professor in the School of Nursing, and it’s time to get the community involved with helping teens quit.

"Teen smoking is a community problem that requires community intervention," said Dr. Kathleen Stevens, director of the Academic Center for Evidence-Based (ACE) Nursing. "Smoking cigarettes is the most important preventable cause of death in the United States and is responsible for more than 430,000 deaths each year. We’re moving into the community with the San Antonio Teen Tobacco Coalition to help address this important issue affecting teens."

The Teen Tobacco Coalition isn’t just sending smoke signals.

"The coalition wants to establish a sustainable, synergistic network of community resources for intervention; this is not a prevention program," said Dr. Stevens, about the $150,000 program that’s based out of the ACE center. "The coalition has worked hard to bring the intervention program to two school districts, the Judson and San Antonio Independent School Districts."

Photo by Fernando Serna

How does the teen coalition hope to achieve success? By partnering with the American Lung Association (ALA) and other local community organizations.

"We’re patterning our intervention after the ALA’s ‘Not On Tobacco (NOT)’ program, which is shown to be the most effective in smoking cessation in teens to date," said Dr. Stevens, about the multi-session program developed specifically for teens who are addicted to smoking. "Not On Tobacco, which is supplemented with booster programs and facilitated through school personnel, has more than a 20 percent quit rate."

Standard Care, another program recommended by the U.S. Surgeon General’s Office, includes assessing, advising and assisting in smoking cessation, but only produces a 5 percent quit rate, says Dr. Stevens.

"The availability of tobacco, cultural tolerance, educational levels and socioeconomic differences make smoking cessation a top priority," she said, also noting that while most teens who smoke want to quit, they lack the ability or support necessary to do so. "According to a national survey, only about 1.5 percent of adolescents who ever smoked were successful at quitting. Not On Tobacco does help teens quit by addressing life skills, refusal skills, peer pressure stress management and coping."

Both the initial success of the NOT program and the local need for effective youth tobacco control programs prompted Dr. Stevens to activate the San Antonio Teen Tobacco Coalition. The University Health System-funded project will not only evaluate the effectiveness of the NOT program in our area schools, but also will set up the program to continue beyond the conclusion of the evaluation research period. The NOT program is slated for training and preparations this fall and the "go live" date is in January.

The Teen Tobacco Coalition goals are:

  • Identify and endorse "best practice" in smoking cessation for San Antonio youth.
  • Guide implementation of a school-based smoking cessation program.
  • Maximize our community resources to help teens quit smoking.
  • Develop ways and means to sustain continued work.

The school-based intervention is specifically looking at smoking behavior and life skills that will lead to healthier choices.

"With the 10-week, school-based program, we want to produce a four-fold increase in the number of teens who quit smoking," said Dr. Stevens, noting that one of every three San Antonio area high school students smokes cigarettes and 75 percent have tried smoking.

"We want to help them stop because of the dire health consequences of tobacco use on immediate and long-term health," she added.

She notes that research is beginning to point to three types of smokers: Those who no matter how much they smoke don’t become addicted, those who take one year to become addicted and those who smoke one to five cigarettes and become addicted.

Tobacco facts

  • Among U.S. adult smokers, 82 percent tried their first cigarette and 53 percent became daily smokers before the age of 18.
  • Lung cancer has surpassed breast cancer as the leading cause of cancer death. Between 1950 and 1990, lung cancer deaths among women increased more than 500 percent.
  • By 2020, tobacco will be the world’s leading cause of premature death and disability. In 1990, tobacco caused three million deaths per year worldwide; by 2020 tobacco will cause 8.4 million deaths worldwide.
  • The smoking-attributable costs of complicated births were $1.5 billion in 1995, representing 11 percent of the costs for all complicated births.
  • The overwhelming majority of female smokers—both teen and adult—feel dependent on their cigarettes. This includes smokers as young as 12 years of age.
  •  Women who smoke while pregnant risk the life and health of their developing child. In 1996, more than 400,000 American women reported smoking during their pregnancies (13.6 percent of all births).
  • About half of Americans who have ever smoked have quit. In 1995, 19.3 million people were former smokers.

Pregnant women who quit in the first trimester and stay tobacco-free throughout their pregnancy can largely protect their developing child from the hazardous effects of smoking.

Although nicotine is being studied as a possible therapy for a broad range of ailments that includes Alzheimer’s and Parkinson’s diseases, schizophrenia, depression, adult attention deficit disorder, Tourette’s syndrome and ulcerative colitis, "We’re just beginning to assess evidence on how nicotine affects the brain," said Dr. Stevens.

What is known, though, is that it is healthier to never start smoking.

—Fernando Serna