[Considering and tackling tobacco smoking in the context of adolescent development]

The prevalence of smoking among young people is still on a high level. Many adolescents are incessantly attracted by advertising and other messages promising a fashionable, young and independent lifestyle with cigarettes as imperative symbols. Those adolescents suffering from cognitive, mental or social problems or being genetically more vulnerable have the greatest risk to misuse nicotine and to become addicted for many years. Unfortunately, being diagnosed with asthma or diabetes does not deter adolescents from smoking, thus increasing the burden of their chronic disease. Of similar concern is the considerable number of smoking young people at the reproductive age. In the last few years, only modest progress has been observed in the development of programmes, which are suited to diminish the rate of young smokers. There is a lack of effective strategies that could help them to get motivated and to stop smoking. Primary care physicians are in an unique position to contribute to adolescent smoking cessation. This article provides information to physicians on how to best accomplish this task. In order to reach sustainable changes in adolescent smoking behaviour, rigorous political steps are necessary which target on diminishing the social acceptance and attractiveness of smoking in general and on the reduction of the number of adult smokers, rather than exclusively focussing on adolescent smoking. This policy has to be supplemented with comprehensive steps to improve education and future life perspectives of adolescents.