Smoking Teenagers: Parenting Dos and Don’ts

These suggestions for parents come from Lyndon Haviland, executive vice president of the American Legacy Foundation (a public health foundation created as part of the 1998 settlement agreement by the states with the tobacco companies):

1. Do take nicotine addiction seriously. “When I talk to parents, I sometimes hear, ‘It’s only tobacco’ or ‘They’re just experimenting,’” Haviland says. “It’s critical to understand that teenagers do become addicted, and it’s critical to intervene. For one thing, research shows that cigarettes can be a gateway to use of other drugs and alcohol.”
2. Don’t assume teens know the dangers. While the latest teen smoking stats are promising, there are still warning signs hidden behind the headlines. The Monitoring the Future study showed that 43 percent of eighth-graders still do not believe that there is a great risk associated with a-pack-a-day smoking.
3. Do talk about (immediate) health consequences and the cost. Teens tend to believe they’ll never get pregnant or die in a car crash, so it may be a waste of time to talk about “someday” dying of lung cancer as a result of smoking. Instead, Haviland and other experts advise parents to focus on short-term health and economic effects: “You get a lot of sore throats because you smoke.” “If you want to run cross-country next semester, you’ll have an easier time if you quit.” “Your teeth are starting to get stained.” Or focus on the money they’re spending: “Gee, you could probably afford your own car if you weren’t spending so much on cigarettes!”
4. Don’t underestimate your own influence. “We’ve talked to teens who say, ‘If my mom and dad really cared, they’d push me on it,’” Haviland reports.
5. Do talk to your child’s healthcare provider, athletic coaches, and guidance counselors. The more caring adults who know your child smokes, the better, Haviland says. “You’re surrounding your teen with support for cessation behavior. There is nothing wrong with saying to a soccer coach, ‘My daughter will be playing on your team in the fall and I want you to know that she began smoking over the summer.’”
6. Don’t turn cigarettes into a “forbidden fruit.” No-smoking rules are fine, but only if they are premised on the dangers associated with cigarettes, not just “Those are my rules and you must obey.” Make sure you tell your teen how much you admire and respect his or her decision not to smoke, or to quit.
7. Do look for help. The American Lung Association has a comprehensive program for teens called “NOT.,” — “Not On Tobacco.” Check their website for details at www.lungusa.org. Or visit www.quitnet.com. This site has a calculator to help teens (and adults!) calculate the savings they reap when they kick the habit.

Cutting oneself is the most common form of SI, with over 64% of teenagers choosing the method. This form of deliberate self harm involves the use of an object to cut or wound one’s own body. Teenagers will use razors, paper clips, geometric instruments, needles or even knifes and scissors. Usually teenagers cut themselves on arms, wrists, legs, bellies and thighs. While girls are believed to be more prone to teen cutting, teenage boys also injure themselves.

Reasons for Teen Cutting

In the transition period from childhood to adulthood, teenagers can be confused about the ‘grown-up’ way to deal with a problem or the emotions that are suddenly taking hold of them, and may resort to cutting as a way of taking control. If parents view deliberate self-harm as a coping mechanism rather than an act of defiance or a suicide attempt, it can be handled more effectively.

In many other cases, teen cutting is driven by emotional or mental needs, as a way of dealing with feelings that the teen is unable to bear. Research has shown that anger and anxiety are the most prevalent causes for deliberate self harm. Cutting oneself is thought to release endorphins in the system, causing a temporary ‘high’ for the cutter. Teenagers who have the following traits are vulnerable to teen cutting:

• Low self esteem
• High anxiety or anger
• Hypersensitivity
• Feelings of rejection
• An underlying condition such as bipolar disorder or depression

Reasons for Deliberate Self Harm

Apart from being an obvious or hidden call for attention or help, teen cutting involves a number of other risks. Using or sharing unhygienic instruments can cause infection, inflammation and increases the chances of contracting various transmittable diseases. Cutting oneself too deep or too hard could lead to veins, arteries or tendons being severed. Given that teenagers are vulnerable to experimenting with drugs, alcohol or risky behaviour, the combination of injury or excessive bleeding in an isolated place or in the company of other intoxicated teens could even be fatal.

Teen Cutting – Recognizing the Signs

Many teenagers will hide their scars or injuries, and feel ashamed of them. As they are already struggling with fitting in or being part of a group, their worries about being rejected, mocked or considered weird can often be a deterrent to them asking for help with deliberate self harm. The act of cutting oneself is a very personal, intimate act that teens will be secretive about even if they are not ashamed. When talked to about the issue of teen cutting, they vary in their reactions – some admit that it is dangerous, does not solve the problem and that they would like to stop, while some are reluctant to stop the habit. Often teens will talk about their habit of deliberate self harm to someone, or find a way to let people know about the injuries. Many of them, however, are unwilling to give up even the short-term relief that they feel from the habit, despite knowing it is destructive and harmful.

The most common signs of teen cutting are unexplained injuries on the body of your teenage child, with vague explanations for the cuts. Teenagers who become quiet and withdrawn suddenly or start to wear clothes that cover arms and legs even in summer or on holiday, (although all these symptoms could be just teenage whims) may be practising deliberate self harm.

It is important for parents or care-takers to understand or at least accept the difference between deliberate self-harm and self-decoration such as multiple tattoos or piercings. Often, it takes time and patience for a teenager to stop the habit of cutting oneself, but sometimes, therapy may be required. Discussing the problem of teen cutting with a counselor or trained professional before addressing the problem may help parents to gain perspective.

References:

1. Cutting – Kids Health

2. What is Self Injury? – Focus Adolescent Services

3.  AAMFT Consumer Update Adolescent Self Harm – American Association for Marriage and Family Therapy

• Talk to your teen first: Teenagers tend not to share their lives with their parents as much as when they were children and depressed teens will be even more reluctant. Setting aside a time to talk to your teen in an affectionate, non-confrontational manner is important. Refrain from suggesting depression; instead mention the behavioral changes you have noticed and explain why it is worrying for you. Listen to their answers without judgment or without trying to offer advice. This may be easier said than done, since teenagers, especially depressed teens, do not like to be questioned or to share their lives with parents. However, it is important you let them know you are there for them and will try to support them as much as possible.

• Avoid giving advice or counseling: When a teen talks about teenage depression symptoms, acknowledge their feelings. Trying to talk them out of it or make them look on the brighter side is not likely to work, and will make them feel you are treating them like children. Acknowledging their confusion or pain, encouraging them to talk and refraining from offering advice is most helpful, and will ensure that the depressed teen feels safe and comfortable.

• Getting medical help: When depressed teens deny symptoms or cannot explain his or her strange behavior, it is often safer to talk to a medical expert. Without qualified diagnosis, depression in adolescents can become serious and could cause harm to the teenager or to others around. Visiting a family doctor and talking about the teenage depression symptoms, the health of the teenager, and any family history of depression can help. When the doctor conducts the examination, he or she will test for signs of depression.

• Further medical help: A family doctor can either recommend a psychologist or psychiatrist if there are no health issues that are causing the teenage depression symptoms. Talking to a mental health expert who specializes in treating children and teenagers is likely to help. Make sure you listen to your child’s opinion about the expert. If the child is not comfortable talking to the expert, the visits are not likely to help.

• Medication: Medication of depressed teens should be only undertaken on professional advice after other methods have been tried. Discuss the side effects of medication on a teenage body and opt for the one that best suits your child’s needs. Medication may give immediate relief from teenage depression symptoms but the damage may be long-lasting.

Teens with Depression

Depression in adolescents is caused by a combination of factors. It could be a physical cause, such as the hormone spurt that the teen is experiencing, as well as the stressful process of physical and emotional maturation. It could also be a situational cause, triggered by events or feelings from the environment or life that the teen is experiencing. Family conflict, struggles with parents to assert oneself, break-ups or sexual misadventures, failure at school or feelings of being isolated, or death of a friend or loves one can all cause teenage depression symptoms. Depression in adolescents is treatable, but in some cases can continue into adult years.

Risk Factors for Depression in Adolescents

• Children from broken homes due to death or divorce
• Care giving that is irregular or negative
• Victims of physical or sexual child abuse
• Children with a family history of depression
• Inability to interact socially
• Adolescents with low self-esteem or self-loathing
• Adolescents with negative body image
• Teens who indulge in substance abuse

Recognizing Teenage Depression Symptoms

While girls are more susceptible to teenage depression symptoms than boys, the concern is that depression in adolescents is hard to diagnose. Most parents or caregivers assume that ‘teenagers are just being teenagers’ when they display signs such as irritability, anger, withdrawal from family, sleeping late in the mornings and staying up late at night. However, as an alert parent or caregiver, distinguishing between teens with depression and normal teenagers on a bad day can make all the difference.

• Changes in behavior: Changes in sleeping patterns, daytime sleepiness, and loss or increase of appetite can be teenage depression symptoms. Other behavior such as missing school, shoplifting, indulging in criminal activity, or deliberately defying instructions can indicate depression.
• Mood swings: Teens with depression will seem irritable, will often cry for no apparent reason, will be more forgetful than normal, and may even have problems concentrating or making decisions.
• Social signs: Depression in adolescents often causes them to withdraw from family members and sometimes friends, choosing to spend time with a different set of peers or only one friend. They become less interested in activities, especially family activities, and could spend a lot of time alone.
• Self-image: Depression is caused by or could result in a low sense of self-esteem, as well as feelings of worthlessness. Teens with depression often say things like “What’s the point of it all?” or “It makes no difference”.
• Thoughts of death: Depression in adolescents can sometimes lead to thoughts of suicide or homicide. It could also lead teenagers to worry about death of their family or loved ones. This is one of the most serious teenage depression symptoms and should not be ignored.

Normal Behavior & Teenage Depression: Knowing the Difference

Deciding if teenage depression symptoms are normal teenage behavior or medical symptoms is difficult because it is also the natural behavioral tendencies of adolescents around the world. However, it pays to ask the following questions to decide if your child or ward suffers from depression in adolescents.

• Does this behavior differ greatly from the norm?
• How long has this been going on?
• How severe are the symptoms?
• Are there any signs of substance abuse?
• Are there signs of eating disorders?
• Are there signs of self-injury (cutting, burning, hair pulling)?

Adolescents with long-lasting behavior that is a dramatic change from the usual behavior are likely to be depressed. Complaints of headaches and stomach aches are also a common sign, especially if there is no medical or physical reason for the ailment.

References:

1. Depression in Children & Adolescents – National Institute of Mental Health
2. Adolescent Depression – University of Maryland Medical Center

• Weight problems: Children who were considered plump can grow into overweight or obese teenagers as they begin to be less active, snack on unhealthy food, and spend more time in sedentary activities alone or with friends. Overweight teens are one of the most common teenage health issues. Discussing diet options with them may be difficult, especially if their weight is a sensitive issue. Instead, keep the fridge stocked with healthy and low-fat food options, as well as plenty of fruit, vegetables and juice

• Eating Disorders: With teenage years come increased peer pressure and heightened sensitivity to the opposite sex and to the media’s norm of an attractive man or woman. These years are the most common age for eating disorders to set in: anorexia, bulimia and a range of other complications can affect the health of a teenager. If you suspect an eating disorder, it is best to get medical advice or counseling from adolescent health care authorities.

• Body Image: As teenagers feel their bodies mature into adults, they begin to take more control over their privacy and self-expression. Wanting to get body parts pierced or tattoos done is a way to create an identity of their own. Most teenagers are very body conscious and many do not like their bodies or appearances. Counseling can help, as will discussing the health of adolescents, more active lifestyles and possibly a change of wardrobe.

• Skin Problems: Teen skin faces the brunt of all the hormonal changes that the body goes through. With excess oil production and perspiration, as well as sudden increase in use of make-up and beauty products, skin can get inflamed and develop pimples or acne. This teenage health issue causes a great deal of self-conscious suffering for adolescents. Encourage teens to wash their faces often and maintain hygiene, or get medical help if prescriptions are needed. Another problem during this time is the appearance of stretch marks as bodies grow rapidly, or skin rashes caused by tanning, shaving or hair removal.

• Sexual Health: As parents, facing the idea of adolescents engaging in consensual sexual activity is a daunting, if not frightening one. However, teenagers today are more sexually aware and more sexually active than previous generations. Discussing puberty and maturation of the body is usually not as difficult as discussing sexual health and related issues. If you are not comfortable talking to your child about their sexuality, let them talk to a doctor, counselor or adolescent health care expert. Teens need to know about STDs, teenage pregnancy, birth control and sexual cleanliness.

• Depression and Stress: Adolescent health care often deals with teenagers who are susceptible to stress and depression as they grow and mature. Treating teen depression as something ‘they’ll grow out of’ when it is serious clinical depression can cause effects that last well into adulthood. Teen suicides are often ascribed to depression or a feeling of isolation. If you suspect your child is depressed, talking to a counselor or medical expert is recommended.

• Addictions: The health of adolescents as well as their lives can be seriously affected by an addiction. Teenagers may experiment with tobacco, drugs and alcohol either because of peer pressure or out of curiosity. A teenager who has discussed these habits and their ill effects with parents, and who has been made aware of the dangers is less likely to let an experiment develop into a habit. If you feel your child has developed an addiction or a habit, enrolling them in counseling is a good option.

References:

1. Teens Health – Kids Health
2. Teenagers: How to Stay Healthy – Family Doctor

To make sure that you are able to guide them through the turbulent phase of puberty problems, you have to establish an open, sensitive communication style with them. Handling children who are going through puberty is a delicate task. Most teens pretend they know everything, and cover up insecurity or embarrassment with a cocky or defensive exterior. Parents will have to find ways to communicate puberty information without hurting feelings or without the child feeling like he or she has no privacy.

Puberty Problems and Emotions

While all adults know the changes they went through during puberty, it is a good idea to go through a few books or do some research online. This not only helps to refresh adult memories about teenage worries or concerns, it also provides ways to discuss puberty information. For single parents who need to have the puberty talk with their child of the opposite sex, this is vital to understanding their puberty problems.

Most children experiencing puberty problems are embarrassed about the physical changes. Girls with developing breasts or boys with voices that are breaking are likely to be teased by their peer groups, especially if they are amongst the earliest to develop. The growth of pubic hair or beards can cause shame or shyness too. Teens with acne, excessive perspiration or oily skin or hair could be embarrassed by the changes.

Communicating Puberty Information

• Having the puberty talk with your child, regardless of age, should be during a time when the child is free from distraction and stress. For many children, discussing awkward issues while performing a repetitive task such as peeling potatoes or washing dishes makes it easier as they don’t have to look directly at the parent or caregiver.
• Start off with a brief discussion of the puberty information, just touching upon all points. Children will want to think about facts they learn and come back later to discuss them further.
• Encourage children to talk about themselves, instead of immediately telling them what they should expect. No child experiences puberty problems exactly the same way, even within the same family, and they will have questions or concerns of their own.
• In addition to talking to children, provide reading material for them to go through. Keeping a few books with puberty information in the child’s bedroom can take care of the questions that your child is curious about but is afraid to ask.

It is also important that parents provide some puberty information about the changes happening to the opposite sex. Teenagers are naturally curious about the changes within themselves and others, as well as sexually curious. Explaining puberty information to your child can help your child become more aware, more sensitive, and more cautious.

Reference:

1. Puberty – Keep Kids Healthy