Join us at noon CT (1 p.m. ET/10 a.m. PT) on Tuesday, Feb. 1, for an hour-long chat about kids and tobacco.

The vast majority of smokers -- almost 90 percent -- took their first puff at or before the age of 18. According to some studies, more than 5 million children alive today will die prematurely from smoking-related illnesses. On Feb. 1, Chicago Tribune health reporter Deborah L. Shelton will host a live chat to talk about the implications of kids and tobacco.

Joining us to talk about the latest research on the impact of tobacco on children and efforts to prevent minors from using tobacco products will be:

Danny McGoldrick, Vice President for Research at the Campaign for Tobacco-Free Kids




Dr. Jonathan Winickoff, associate professor of pediatrics at Harvard Medical School and a member of the American Academy of Pediatrics Tobacco Consortium



If you are unable to make the chat, or would like to send your question in advance, e-mail Deborah Shelton at dshelton@tribune.com.

 Health Chat: Kids and tobacco(02/01/2011) 
11:49
Chicago Tribune: 
Thank you for joining our chat. It will start at noon so please standby.
Tuesday February 1, 2011 11:49 Chicago Tribune
12:00
Deborah L. Shelton: 
Hello everybody! Welcome to the web chat on kids and tobacco. I’m Deborah Shelton, a Chicago Tribune health reporter, and moderator of today's chat.

As you probably read on our chat promo: The vast majority of smokers -- almost 90 percent -- took their first puff at or before the age of 18. According to some studies, more than 5 million children alive today will die prematurely from smoking-related illnesses. Those are sobering statistics.
Tuesday February 1, 2011 12:00 Deborah L. Shelton
12:00
Deborah L. Shelton: 
Joining us to talk about the latest research on the impact of tobacco on children and efforts to prevent minors from using tobacco products are: Danny McGoldrick, Vice President for Research at the Campaign for Tobacco-Free Kids, and Dr. Jonathan Winickoff, associate professor of pediatrics at Harvard Medical School and a member of the American Academy of Pediatrics Tobacco Consortium.

Thank you both for joining us.
Tuesday February 1, 2011 12:00 Deborah L. Shelton
12:00
Jonathan Winickoff: 
nice to be with you
Tuesday February 1, 2011 12:00 Jonathan Winickoff
12:00
Danny McGoldrick: 
Thanks for having us, Deborah. Great to be here.
Tuesday February 1, 2011 12:00 Danny McGoldrick
12:00
Deborah L. Shelton: 
Anyone with questions is encouraged to shoot them our way. The earlier, the better! Please post, as I am not checking e-mail during this live event.
Tuesday February 1, 2011 12:00 Deborah L. Shelton
12:01
Deborah L. Shelton: 
I'll start with some basic questions while the chatters formulate their questions. One or both of you can jump in at any time.

Maybe we can start by talking about the second-hand effects of smoke on children. Numerous studies have been done on the effect of second-hand smoke, what are some of the newer findings about how it impacts health?”
Tuesday February 1, 2011 12:01 Deborah L. Shelton
12:01
Danny McGoldrick: 
The 7000 chemicals, including hundreds of toxic substances, in secondhand smoke are bad for anyone who breathes them, but kids are particularly vulnerable. Secondhand smoke is a known cause of cancer, heart disease, and many other illnesses. Kids who are exposed have immediate impacts as well, including respiratory infections like bronchitis or pneumonia, increased asthma attacks, and more ear infections. Secondhand smoke even contributes to sudden infant death syndrome.
Tuesday February 1, 2011 12:01 Danny McGoldrick
12:03
Jonathan Winickoff: 
Secondhand smoke can also affect nicotine receptors in the brain, making children more likely to enjoy smoking when they first try a cigarette.
Tuesday February 1, 2011 12:03 Jonathan Winickoff
12:03
[Comment From djmdjm: ] 
Is there any safe amount of smoke exposure or is any amount of exposure toxic to kids/adults?
Tuesday February 1, 2011 12:03 djm
12:03
Danny McGoldrick: 
The recent Surgeon General's report released at just the end of last year concluded that there is no safe level of exposure to tobacco smoke. The effects of tobacco smoke can begin immediately.
Tuesday February 1, 2011 12:03 Danny McGoldrick
12:05
[Comment From Federico WustFederico Wust: ] 
What has been effective to keep children away from starting their first cigarrette?
Tuesday February 1, 2011 12:05 Federico Wust
12:06
Deborah L. Shelton: 
Thank you for the great question.
Tuesday February 1, 2011 12:06 Deborah L. Shelton
12:06
Jonathan Winickoff: 
parents and household members should do what they can to quit themselves. Also a strong message about how parents feel about not smoking and the importance of not smoking. make it clear there will be real consequences in terms of discipline if smoking occurs.

Tuesday February 1, 2011 12:06 Jonathan Winickoff
12:07
Jonathan Winickoff: 
limit children's exposure to film with heavy smoking
Tuesday February 1, 2011 12:07 Jonathan Winickoff
12:07
[Comment From katie v.katie v.: ] 
are there any policy based solutions to youth access to tobacco? or do you think that education is more effective?
Tuesday February 1, 2011 12:07 katie v.
12:07
Danny McGoldrick: 
Preventing illegal sales of tobacco to kids requires periodic unannounced random compliance checks with meaningful penalties for violators. This has been shown to reduce tobacco sales to kids. Merchant education can be helpful, but it's really the compliance checks that work and that are necessary to reduce sales to kids.
Tuesday February 1, 2011 12:07 Danny McGoldrick
12:08
Deborah L. Shelton: 
You're talking about all stores that sell tobacco, right?
Tuesday February 1, 2011 12:08 Deborah L. Shelton
12:10
Jonathan Winickoff: 
Many children in multiunit housing are exposed to higher levels of tobacco smoke and have more neighboorhood stores that sell cigarettes.
Tuesday February 1, 2011 12:10 Jonathan Winickoff
12:11
Danny McGoldrick: 
Yes, compliance checks should be conducted for all tobacco retailers.
Tuesday February 1, 2011 12:11 Danny McGoldrick
12:12
[Comment From Joel AfrickJoel Africk: ] 
From a policy standpoint, there is a lot of evidence that high cigarette taxes dissuade kids from smoking.
Tuesday February 1, 2011 12:12 Joel Africk
12:12
Deborah L. Shelton: 
Mr. Africk is president and CEO of the Respiratory Health Association Of Metropolitan Chicago .
Tuesday February 1, 2011 12:12 Deborah L. Shelton
12:12
Jonathan Winickoff: 
children are very sensitive to price increases--great point
Tuesday February 1, 2011 12:12 Jonathan Winickoff
12:13
Danny McGoldrick: 
Increased tobacco taxes are one of the best ways to reduce smoking, particularly among kids -- who are more price responsive than adult smokers. Increasing tobacco taxes is a WIN WIN for states; they reduce smoking but also produce important new revenue for states in these tough budget times.
Tuesday February 1, 2011 12:13 Danny McGoldrick
12:13
[Comment From MMMM: ] 
Any thoughts on electronic cigarettes? Any challenges to their sales use and regulation.
Tuesday February 1, 2011 12:13 MM
12:14
Danny McGoldrick: 
Electronic cigarettes should be regulated for safety and efficacy by the FDA like other nicotine replacement therapies (NRT) like the gum and patch. There may one day be a way to get smokers to quit, but right now, they have not been proven either safe or effective.
Tuesday February 1, 2011 12:14 Danny McGoldrick
12:15
[Comment From Lisa MLisa M: ] 
What are the most vulnerable groups of youth affected by smoking advertisements and at risk of becoming addicted?
Tuesday February 1, 2011 12:15 Lisa M
12:17
Deborah L. Shelton: 
For more information on kids and tobacco, go to: http://www.aap.org/richmondcenter/
Tuesday February 1, 2011 12:17 Deborah L. Shelton
12:17
Danny McGoldrick: 
Well, we know that kids in general are much more vulnerable than adults to tobacco advertising,and we also know that kids are more likely than adults to report exposure to tobacco advertising. Among kids, sensation seeking kids, those who like to take risks, are more vulnerable, but we need to restrict tobacco advertising to all kids.
Tuesday February 1, 2011 12:17 Danny McGoldrick
12:18
[Comment From BillWBillW: ] 
But do kids really have a choice? Isnt it that they are a victim of the environment they live in?
Tuesday February 1, 2011 12:18 BillW
12:20
Danny McGoldrick: 
Kids' behaviors are definitely affected by their environment, which is why we need to take steps to create an environment that is less conducive to smoking and other tobacco use. We do that by passing smoke-free laws, increasing tobacco taxes, and putting in place tobacco prevention and cessation programs. We know from the science that those measures work to reduce smoking.
Tuesday February 1, 2011 12:20 Danny McGoldrick
12:21
[Comment From Kate L.Kate L.: ] 
For many middle and upper class Americans, it seems like it comes as a surprise that tobacco use continues to be an issue in the U.S. This surprise makes sense given that tobacco companies prey on individuals and groups from low socio-economic status demographics. What recommendations do you have to heighten awareness of this issue across the board?
Tuesday February 1, 2011 12:21 Kate L.
12:21
Jonathan Winickoff: 
Smoking is one of the health behaviors that varies most by socio-economic status. pack a day smoking costs over $2000 per year--money that poor families cannot afford. Helping folks who smoke gain access to medication and counseling should be a national priority. Free state quitlines are available in all 50 states, 1-800-Quit-NOW...
Tuesday February 1, 2011 12:21 Jonathan Winickoff
12:22
[Comment From Federico WustFederico Wust: ] 
How about narguile, narguila, water pipes, hookah? Is this safe to smoke?
Tuesday February 1, 2011 12:22 Federico Wust
12:23
Deborah L. Shelton: 
Thanks for the question Federico. There are lots of other products out there other than cigarettes that concern parents and health professionals.
Tuesday February 1, 2011 12:23 Deborah L. Shelton
12:23
Danny McGoldrick: 
The tobacco companies oppose tobacco taxes for the same reason the public health community supports them: They know it reduce sales of their products. They use arguments like smuggling and cross-border sales because they can't argue it's better if more people smoke. There will be some of this in the wake of tobacco tax increases, but the benefits of tobacco taxes far outweigh any tax evasion efforts. Also, steps like high tech tax stamps can be taken to reduce illegal sales, and federal legislation has been passed to limit illegal internet sales.
Tuesday February 1, 2011 12:23 Danny McGoldrick
12:24
Jonathan Winickoff: 
With regard to water pipes...There is no safe tobacco product. We have a paper coming out on these products--and can follow that research on twitter @mghfc

people often learn to smoke cigarettes in hookah bars
Tuesday February 1, 2011 12:24 Jonathan Winickoff
12:25
[Comment From Federico WustFederico Wust: ] 
Hi Deborah. I am the Executive Director of the Fundacion Pro Derecho de los No Fumadores (FUPRODENOF) based out of Costa Rica, and creator of the FB group Que Prohiban Fumar en Sitios Publicos en Costa Rica. We are currently fighting to have the TI our of our laws! They are really powerful, and some Congressmen are already supporting them...
Tuesday February 1, 2011 12:25 Federico Wust
12:26
[Comment From Joel AfrickJoel Africk: ] 
According to a Mayo Clinic report, smoking hookah for one hour is the equivalent of smoking 100 cigarettes. Yuk.
Tuesday February 1, 2011 12:26 Joel Africk
12:27
[Comment From C.GC.G: ] 
What can physicians do to work on these issues in their communities and states? What resources are available to them?
Tuesday February 1, 2011 12:27 C.G
12:27
Jonathan Winickoff: 
We have a program for pediatricians to help every family member quit and to help pediatricians get involved with advocacy on this issue. www.ceasetobacco.org

we also have a CME and maintenance of certification course for pediatric offices available at the American Academy of Pediatrics Richmond Center AAP.org
Tuesday February 1, 2011 12:27 Jonathan Winickoff
12:30
[Comment From MaloneyMaloney: ] 
With cigarettes taxed at a much higher rate than other tobacco products is there evidence of youth trending towards cigars and roll your own tobacco?
Tuesday February 1, 2011 12:30 Maloney
12:33
Deborah L. Shelton: 
To learn more on the topic of kids and tobacco, go to: http://www.tobaccofreekids.org/
Tuesday February 1, 2011 12:33 Deborah L. Shelton
12:36
Chicago Tribune: 
We are currently having technical difficulties with posting Dr. Danny McGoldrick's responses. Please standby. His response is: "To ensure that kids don't simply use lower priced tobacco products, it's important that tax rates on smokeless tobacco, cigars, and other tobacco products are comparable to those for cigarettes."
Tuesday February 1, 2011 12:36 Chicago Tribune
12:36
[Comment From GregoryGregory: ] 
I'm glad this discussion about tobacco and kids is going on. However, we also have to talk about recreational drug use, and the abuse of prescription drugs. Cigarettes kill slowly, while some of these recreational drugs kill at a much shorter time. We have to address those issues as well. :)
Tuesday February 1, 2011 12:36 Gregory
12:36
Jonathan Winickoff: 
General comment...Tobacco use turns out to be a gateway to other drug use so getting a handle on this problem will resonate and created lower use of other drugs.
Tuesday February 1, 2011 12:36 Jonathan Winickoff
12:37
[Comment From Joel AfrickJoel Africk: ] 
We are working with physicians and others in Chicago to get all clinicians to use a two-minute intervention with their patients called Ask, Advise, Refer, in which every patient is asked if he/she smokes, is advised to quit, and referred to a local telephone quit line or other available resources in his/her area--this is sponsored by Chicago Tobacco Prevention Project, a program we are working on with Chicago Department of Public Health.
Tuesday February 1, 2011 12:37 Joel Africk
12:38
Jonathan Winickoff: 
Great program... let's add in patch and gum access for parents. We can talk off line... check out ceasetobacco.org for more parent specific materials!
Tuesday February 1, 2011 12:38 Jonathan Winickoff
12:39
[Comment From Federico WustFederico Wust: ] 
What can you tell a teenager about the immediate effects on their bodies by smoking one cigarette? Long term diseases are not that important to them. They will worry about it when they have to face it. What can we tell them today, of the damages today?
Tuesday February 1, 2011 12:39 Federico Wust
12:39
Danny McGoldrick: 
Teenage smokers suffer from shortness of breath almost three times more often as teens who don't smoke, and produce phlegm more than twice as often as teens who don't smoke. Not surprisingly, smoking also hurts young people's physical fitness in terms of both performance and endurance -- even among young people trained in competitive running
Tuesday February 1, 2011 12:39 Danny McGoldrick
12:40
Danny McGoldrick: 
Chronic coughing, increased phlegm, emphysema and bronchitis have been well-established products of smoking for decades; and smokers are also more susceptible to influenza and more likely to experience severe symptoms when they get the flu
Tuesday February 1, 2011 12:40 Danny McGoldrick
12:41
Jonathan Winickoff: 
smoking even a few cigarettes can cause teens to be primed for addiction. The first step is simply wanting a cigarette... it then goes to craving and needing after very few... smoking any cigarettes is not safe due to risk of long term addiction
Tuesday February 1, 2011 12:41 Jonathan Winickoff
12:41
Deborah L. Shelton: 
We're taking your questions. Live. Send early, send often!
Tuesday February 1, 2011 12:41 Deborah L. Shelton
12:41
[Comment From MarshallMarshall: ] 
I doubt kids are using roll your own. SCHIP raised the taxes 2400%
Tuesday February 1, 2011 12:41 Marshall
12:41
Danny McGoldrick: 
The tax on roll your own was ridiculously low; it is now taxed comparably to cigarettes at the federal level.
Tuesday February 1, 2011 12:41 Danny McGoldrick
12:42
[Comment From katie v.katie v.: ] 
smoke free housing policies are expanding in some states (like CA where I am). do you see this being the next frontier for tobacco prevention? it's a very controversial issue...
Tuesday February 1, 2011 12:42 katie v.
12:43
Jonathan Winickoff: 
It is controversial but important for children to breath clean air where they live and sleep.
Tuesday February 1, 2011 12:43 Jonathan Winickoff
12:43
[Comment From Tobacco Free Boone CountyTobacco Free Boone County: ] 
Do you ever see the CDC using their funding power to force states and municipalities to enact comprehensive "smokefree air" laws and policies much like federal highway funding as done with drinking age laws?
Tuesday February 1, 2011 12:43 Tobacco Free Boone County
12:43
Danny McGoldrick: 
The CDC has not done this for smoke-free laws. They have offered assistance to states and communities to educate about the harms of secondhand smoke.
Tuesday February 1, 2011 12:43 Danny McGoldrick
12:45
Deborah L. Shelton: 
What percentage of teen smokers become lifelong smokers?
Tuesday February 1, 2011 12:45 Deborah L. Shelton
12:45
Jonathan Winickoff: 
Half of all teenagers who smoke in high school becom regular smokers as adults. half of all tobacco users will die of a tobacco attributatble disease.
Tuesday February 1, 2011 12:45 Jonathan Winickoff
12:46
[Comment From Federico WustFederico Wust: ] 
How about butt pollution? How mucha damage to the environment is caused by cigarette butts discarded on the streets and water supplies?
Tuesday February 1, 2011 12:46 Federico Wust
12:47
Jonathan Winickoff: 
A single cigarette butt renders 5 gallons of clean water impotable. Children and animals often ingest butts and over 5000 calls to poison control center calls occur annually.
Tuesday February 1, 2011 12:47 Jonathan Winickoff
12:47
[Comment From Lisa MLisa M: ] 
what about smoking among military personnel and veterans? are youth who join the military more likely to take up smoking and when? In service, after they serve? Are smoking addiction services provided for veterans who are suffering from other post traumatic stress related affects?I imagine many claim smoking helps the stress...
Tuesday February 1, 2011 12:47 Lisa M
12:49
Danny McGoldrick: 
According to data published by the U.S. Department of Defense (DoD), the prevalence of past month smoking among all branches of the U.S. military was 30.6 percent in 2008 , compared to 20.6 percent among adults in the general U.S. population
Tuesday February 1, 2011 12:49 Danny McGoldrick
12:49
[Comment From Federico WustFederico Wust: ] 
How many fires in the US are due to cigarettes?
Tuesday February 1, 2011 12:49 Federico Wust
12:49
Jonathan Winickoff: 
Cigarettes are the single greatest cause of house fire mortality of children. landlords who eliminate smoking in their building actually get a big discount on insurance rates.
Tuesday February 1, 2011 12:49 Jonathan Winickoff
12:50
Danny McGoldrick: 
Tobacco use also places a significant burden on the Department of Defense and VA healthcare systems, costing the systems billions of dollars every year in smoking-caused healthcare costs. According to a 2009 Institute of Medicine Report, Combating Tobacco in Military and Veteran Populations, in 2008 it cost the VA $5 billion to treat smoking-related emphysema and, in 2006, the Military Health System spent about $564 million on tobacco-related health care costs
Tuesday February 1, 2011 12:50 Danny McGoldrick
12:52
[Comment From Joel AfrickJoel Africk: ] 
The VA in Chicago has resources to help veterans and returning active combat soldiers quit smoking.
Tuesday February 1, 2011 12:52 Joel Africk
12:53
Deborah L. Shelton: 
How long does it take before a teen becomes addicted -- when should a parent worry that smoking has gone beyond experimentation?
Tuesday February 1, 2011 12:53 Deborah L. Shelton
12:54
Danny McGoldrick: 
Veterans and any smokers can also call 1-800-QUIT NOW for free help to quit smoking.
Tuesday February 1, 2011 12:54 Danny McGoldrick
12:55
Jonathan Winickoff: 
Experimentation with tobacco is not safe because of the risk of addiction. It takes very few cigarettes to end up a life long smoker... A zero tolerance policy for your children is best. Get on it early... even if you notice that friend of your child is smoking.
Tuesday February 1, 2011 12:55 Jonathan Winickoff
12:55
[Comment From David NevilleDavid Neville: ] 
I've seen dozens of different anti-tobacco ads through the years. Is there a specific one that is better than others I can show my nephews?
Tuesday February 1, 2011 12:55 David Neville
12:57
Danny McGoldrick: 
There is no single ad that works best, but some approaches have worked better than others. Ads featuring real smokers and their stories told in emotional terms have resonated with kids. Campaigns through which kids educate each other about how they are targeted by the tobacco companies have also been effective. See www.thetruth.com
Tuesday February 1, 2011 12:57 Danny McGoldrick
12:58
Deborah L. Shelton: 
What can parents do to keep their kids from smoking?
Tuesday February 1, 2011 12:58 Deborah L. Shelton
12:58
Jonathan Winickoff: 
General comment...strict no smoking policies in your home and car are a good step for every parent to take.
Tuesday February 1, 2011 12:58 Jonathan Winickoff
12:58
Danny McGoldrick: 
You can help keep your kids from becoming smokers in a number of ways. First of all, be a good role model: Don't smoke yourself (call 1-800 QUIT NOW for help in quitting) and make your home and cars smoke-free whether you smoke or not. Send a clear and consistent message to your kids about the dangers of tobacco use and your rules about it. Educate them about the harms of smoking, the difficulty of quitting, and the efforts of tobacco companies to try to get them to smoke. Most important, get involved in community efforts to keep kids from smoking by working to make the community smoke-free, increasing tobacco taxes, and funding tobacco prevention programs. Our leaders need to know you care about these issues. Go to tobaccofreekids.org and click on "Take Action" to learn how to contact leaders in your community about these issues.
Tuesday February 1, 2011 12:58 Danny McGoldrick
12:59
[Comment From KellyKelly: ] 
Are kids that are raised in a house with smokers, more likely to smoke when they become an adult? Do you think it may create a "early addiction" to those kids?
Tuesday February 1, 2011 12:59 Kelly
12:59
Jonathan Winickoff: 
yes, dramatically more likely
Tuesday February 1, 2011 12:59 Jonathan Winickoff
1:00
[Comment From David NevilleDavid Neville: ] 
Tobacco used to be a big issue. I feel like it doesn't get much attention now a days because of prescription pills and other issues. How can we bring it to the forefront again?
Tuesday February 1, 2011 1:00 David Neville
1:01
Danny McGoldrick: 
Tobacco use remains the leading preventable cause of death in the U.S. killing more than 400,000 Americans every year. 4000 American kids still try their first cigarette every day, and another 1,000 become regular smokers.We have made progress, but we have LOTS more to do.
Tuesday February 1, 2011 1:01 Danny McGoldrick
1:01
Jonathan Winickoff: 
Thank you very much for your questions. What an important topic!
Tuesday February 1, 2011 1:01 Jonathan Winickoff
1:01
Deborah L. Shelton: 
Time flew by! Sorry we cannot accept any more questions.

Thank you to our guest experts for sharing your expertise.
Tuesday February 1, 2011 1:01 Deborah L. Shelton
1:01
Danny McGoldrick: 
Thanks for the opportunity to chat on this issue. Lots of great questions!!
Tuesday February 1, 2011 1:01 Danny McGoldrick
1:02
Jonathan Winickoff: 
Please feel free to catch up on this topic on the web and facebook at ceasetobacco and www.ceasetobacco.org
Tuesday February 1, 2011 1:02 Jonathan Winickoff
1:02
Deborah L. Shelton: 
Come back next week -- same day and time -- to chat about hormone therapy and menopause with Tribune health reporter Judy Graham.

Bye!
Tuesday February 1, 2011 1:02 Deborah L. Shelton
1:02