Dr. Jean Simmons

In some instances, maybe not, says Jean Simmons, Ph.D., clinical psychologist and smoking cessation specialist at the Cleveland Clinic.It may be, she says, that what the researchers were characterizing as symptoms of dependence were in fact something else.

She thinks some of the questionnaire responses may simply underscore teen susceptibility to peer pressure and teen desire to emulate peers or role models who smoke.For instance one nicotine dependence symptom criteria was "sometimes feel I really need a cigarette."Another was finding it "difficult not to smoke when friends smoke."

"For some of the respondents, such questions may have been tapping into a response to peer pressure rather than addiction," says Dr. Simmons.She says these claims could just as easily be signs of environmental influences, rather than symptoms of physiologic addiction."The teens who reported ‘feeling a real need to smoke' might have expected that to happen, because they see that behavior in peers or role models who smoke," she says."Smokers are always saying, ‘I gotta have a cigarette.' Maybe these young experimenting smokers are just mimicking behavior or attitudes they observe in their smoking peers," says Dr. Simmons.She says she is not convinced that the questions were tapping into addiction for all of the kids in the study.

Genetic differences among teenagers may affect their tolerance for and the amount of pleasure derived from nicotine, Simmons says.These factors might also contribute to how much one feels compelled to smoke after the first few puffs of a cigarette.In other words, some kids may be more likely than others to continue smoking and become nicotine dependent.But Dr. Simmons does not believe the study offers convincing evidence that the kids exhibited actual signs of addiction after smoking one or two cigarettes, nor that the results refute the theory held by most addiction specialists that nicotine dependence occurs gradually over years."Basically, the more and the longer one smokes, the greater the risk for addiction."

Parents should avoid power strugglesWhile the Canadian researchers are using the study results to emphasize the importance of starting smoking prevention education or cessation programs as early as possible, Simmons believes it is also important for parents to avoid power struggles with children when expressing concerns about the risks of experimenting with cigarettes.Such struggles increase the risk that smoking will be more appealing as an instrument of rebellion, says Dr. Simmons.Parents should also accept that certain factors that contribute to smoking-such as genetics and peer influence-are beyond parental control.While it is important for parents to make it clear that they do not approve of smoking-which also means not smoking themselves-teens can be guided in other ways, says Dr. Simmons."Support their self-esteem and individuality so that they don't use smoking as a means of establishing independence."

Once most teens start smoking regularly, it is difficult for them to stop, says Dr. Simmons.By age 17, 50 percent of teens who smoke have tried-and failed-to quit; many regret ever starting.What should be one of the strongest deterrents-the fear of developing cancer, heart disease or chronic respiratory ailments-does little to discourage them.These are problems that happen to older people, teens rationalize.Indeed, says Simmons, every day approximately 5,000 children try smoking for the first time.And she says, more than 6 million children alive today will die prematurely because of a lifestyle choice they made as adolescents.

Ultimately, when teens start to smoke, every effort should be made to help them stop."It's important for parents to realize their kids may be addicted and could use their support in helping them quit," says Dr. Simmons.

"The most important thing parents can do for their children is to not smoke," says Jean Simmons, Ph.D., clinical psychologist at one of the Cleveland Clinic family health centers."Most kids who smoke have parents who smoke," says Dr. Simmons.

As early as possible-when a child first notices that some people smoke-parents should talk about its dangers, advises Dr. Simmons, who runs group smoking-cessation programs."Children form ideas about smoking long before they start.De-normalize smoking.Let them know that smoking is not okay for children or adults.In addition to not smoking yourself, do not allow smoking in your home."

Communication is key as well, says Dr. Simmons."It's important to stay in touch with your children," she advises parents.
...
If an adolescent has started smoking, have discussion about the damage smoking causes and make it clear to the child that smoking is addictive, says Dr. Simmons.
...
If they are willing, enroll them in a program if they are having trouble quitting on their own," says Dr. Simmons.

"Again, it is crucial that parents do not smoke.Your message about smoking's harmful effects will be negated by the contradictory message you send when you smoke," says Dr. Simmons."For example, it might make smoking seem like an adult behavior, and more attractive to adolescents."

Smoking and stress Nicotine is a psychoactive drug that produces a pleasurable sensation of relaxation.But it also causes stress in the form of constricted blood vessels, tensed muscles and elevated heart rate."Plus, the pressure to quit, high cost of cigarettes and the increasingly negative social perception of smoking actually cause stress for the smoker," says Dr. Simmons.

"Six months after quitting smoking, people report feeling less stress in their lives and higher self-esteem," Dr. Simmons says.

Botek, Georgianne, D.P.M. – Willoughby Hills | Cover, Cindy, C.N.M. – Willoughby Hills | Gaw, Catherine, Psyd. – Willoughby Hills | Green, Armin, M.D. – Willoughby Hills | Greenfield, Aric, M.D. – Willoughby Hills | Grundfest, Sharon, M.D. – Willoughby Hills | Josell, Regina M., Psy. D. – Willoughby Hills | Polster, Amy, M.D. – Willoughby Hills | Pordon, Cynthia, D.O. F.A.C.C. – Willoughby Hills | Rosenblatt, Steven Matthew, M.D. – Willoughby Hills | Schleuter, Barbara, C.N.M. – Willoughby Hills | Simmons, Jean R., Ph.D. – Willoughby Hills | Stanton-Hicks, Ursula, M.D. – Willoughby Hills | cardiology | dermatology | general surgery | medical oncology / hematology | midwifery | podiatry | psychology
...
Jean R. Simmons, Ph.D.Dr. Simmons is a native of New Orleans, where she received her Bachelor of Arts degree in psychology from Newcomb College of Tulane University.She earned her Doctorate degree in clinical psychology from the University of Kentucky, where she received an award for her dissertation on eating disorders in adolescent girls.She completed a predoctoral internship at the Medical College of Virginia and a postdoctoral fellowship in adult clinical and health psychology at the Cleveland Clinic, joining the Cleveland Clinic Willoughby Hills Family Health Center in October 1999.Dr. Simmons is a member of the Cleveland Psychological Association, the American Psychological Association and the Silvan Tomkins Institute.Her specialty interests include coping with chronic illness, eating disorders, women's health, treatment of insomnia, smoking cessation and affect theory.

Most kids who smoke have parents who smoke," says Jean Simmons, Ph.D., clinical psychologist at Cleveland Clinic Willoughby Hills Family Health Center.

As early as possible -- when a child first notices that some people smoke -- parents should talk about its dangers, advises Dr. Simmons, who runs group smoking-cessation programs."Children form ideas about smoking long before they start.De-normalize smoking.Let them know that smoking is not okay for children or adults.In addition to not smoking yourself, do not allow smoking in your home."

"It's also important to stay in touch with your children," Dr. Simmons advises parents.
...
If an adolescent has started smoking, talk again about the damage smoking causes and the fact that it is an addiction, Dr. Simmons says.She acknowledges that parents need to be careful pressuring teens to quit.
...
"Six months after quitting smoking, people report feeling less stress in their lives, and higher self-esteem," Dr. Simmons adds.