Child Orthopedics

Frequently Asked Questions

Our teenage daughter just started smoking (or maybe we just found out about it, we're not sure). Everyone knows smoking is bad for you. But she's young and active and believes this will protect her. What can we say to change her mind?

Peer pressure among teens is a much more powerful influence than what parents usually have to say. If she's spending time with other friends who smoke, the message to quit my not be present. But if her core group of friends don't smoke, then they may be able to convince her not to continue.

Studies show that girls are more susceptible to low back pain associated with smoking. The greater their exposure to cigarettes, the more likely they will develop low back pain. More people who smoke are depressed or sad, but it's not clear if that's why they start smoking or if tobacco use negatively alters mood.

Studies show that exposure to nicotine decreases blood flow to the discs between the vertebrae in the spine. There's even some evidence that nicotine changes the genetic code. The result is irreversible change at the cellular level in the disc.

Of course, telling teens about these problems doesn't always result in a positive change in their behavior. Many adolescents and young adults simply don't believe anything will ever happen to them.

The most powerful educational tool may be the American Cancer Society's brochure Benefits of Smoking Cessation. This is available on-line at It shows how in the first 20 minutes, blood pressure and pulse start to return to normal. By the end of one day, the risk of a heart attack has gone down.

By the end of the third day without tobacco, nerve endings are starting to repair themselves. The sense of smell and taste increases. Within two weeks to two months the ability to exercise has improved. There's less huffing and puffing and better circulation.

The benefits are outlined up to and including 15 years after quitting. Perhaps something educational by a well-known organization would have an effect -- if not right now, then sometime down the road.

Paula Mikkonen, MD, et al. Is Smoking a Risk Factor for Low Back Pain in Adolescents? In Spine. March 1, 2008. Vol. 33. No. 5. Pp. 527-532.

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