SMOKING: THE TRUTH UNFILTERED

DISCUSSION GUIDE

On PBS (Check local listings)

A half hour special from In the Mix, the award winning PBS series

"Smoking makes you look cool and older." "I can quit any time I want, I won't get addicted." "As long as I stop before I'm twenty or thirty, smoking won't affect my health." "I only smoke lights, so it's okay." These are just a few of the rationalizations, misconceptions and attitudes of young people about smoking and nicotine addiction. No wonder the rate of teen smoking climbs every year, despite staggering tobacco-related death statistics and indisputable health risks. Smoking: The Truth Unfiltered, co-hosted by young supermodel Tyra Banks and featuring Bill Novelli, President of the Campaign for Tobacco-Free Kids, lights up the hard facts and burns down common fictions of tobacco and addiction. Aimed to reach teens who are current smokers as well as discourage those who have not yet started, this program will show young people, in no uncertain terms, that smoking is damaging to their health now – not just years down the road – and that quitting is not only possible, but worth the effort. They will also understand how tobacco companies target and manipulate them into smoking…and what they can do to fight back.

How to Use this Program:

Studies conducted by RMC Research on earlier In the Mix specials have shown that these programs engage the interest of teenagers, deliver information, catalyze discussion on critical issues, as well as promote analytical thinking and a greater sense of self-efficacy among teens. We recommend that you show the entire special in one sitting and then revisit each section followed by discussion. The aim is to encourage thought and allow teens to generate their own creative solutions.

Did you know?

• Smoking causes over 430,000 deaths per year. That's the same as if four jumbo jets crashed every day, killing everyone on board.

• 90% of new smokers are age 18 or younger. The average smoker starts at age 13, and is addicted to nicotine by 14 1/2.

• Each day, about 6,000 young people try a cigarette, and 3,000 more become regular smokers...that's one million new smokers a year. One-third of them will die of tobacco-related illnesses.

• Teen smoking is an early warning sign of future problems. Teens who smoke are three times as likely as non-smokers to use alcohol, eight times as likely to use marijuana, and 22 times as likely to use cocaine.

• In 1994, tobacco companies spent an estimated $5 billion - more than $13 million a day - to advertise and promote cigarettes.

• A recent study found that tobacco advertising and promotions are more effective than peer pressure in luring teens into smoking.

In the Mix Awards

•1997 International Prix Danube for Children's Television

•1997 New York Emmy for Children's Programming

•1996 Finalist, The New York Festivals

•1994 National Emmy for Community Service Programming

•1993 Finalist, Prix Jeunesse

•1992 CPB Gold Award

Smoking: The Truth Unfiltered contains three major sections, along with introductions and commentary by teens, In the Mix reporters, and supermodel Tyra Banks.

This Discussion Guide is divided into the following sections:

Harming Your Health Now...Not Later

Kicking The Habit

Teens as Targets

Selected Resources

For information about In the Mix, including show descriptions and schedules, visit our home on the World Wide Web at www.pbs.org/mix, or e-mail us at InTheMix@pbs.org.

Smoking: The Truth Unfiltered carries one-year off-air taping rights and performance rights. Check your local PBS listings for airtimes.

Note: Videotape copies of the program can be purchased for $69.95 (Plus shipping and handling; includes performance rights and a Discussion Guide), and can be ordered by sending a check or purchase order to: In the Mix, 114 E. 32 Street, Suite 903, New York, NY 10016, or by calling (800) 597-9448. There is a discount of $5.00 per tape on orders of any five or more In the Mix titles.

Other videos of interest to grades 7-12 are available on topics including: Drug Abuse; Teen Immigrants, Gun Violence, Depression and Suicide, Computer Literacy and Careers, Self-Image and the Media, Sports Participation, Media Literacy, Activism, Alcohol and DWI, Dating Violence, Getting Into College, School to Work Transition, Careers, Relationships, AIDS, and others. For a complete catalog, call: (212) 684-3940 or (800) 597-9448, or write to us at: 114 E. 32 Street, Suite 903, New York, NY 10016, or visit our complete show descriptions.

c 1998 In the Mix. Smoking: The Truth Unfiltered is a production of Castle Works Inc. In the Mix was created by WNYC Radio. This special was funded by The Annenberg Public Policy Center, University of Pennsylvania.

SECTION ONE

HARMING YOUR HEALTH NOW...NOT LATER

Nineteen-year-old Andrea Barrow, who started smoking three years ago, finds that her pack-a-day habit is affecting the way she feels. She visits her doctor, who details how smoking has already damaged Andrea's health and what she needs to do to reverse the damage. Dr. William Cahan of Memorial Sloan-Kettering Cancer Center provides some graphic illustrations of what the tar in cigarettes does to a smoker's lungs. In a PSA, twenty-six-year-old Pam describes how emphysema has changed her life forever. Later in the show, a former Lucky Strike model who now suffers from throat and lung cancer offers insight on the difference between cigarette ad images and real life.

What symptoms did Andrea and the other teens describe as related to their smoking habits?

constantly short of breath; easily winded; asthma worsened; chronic bronchitis; exhaustion, pain in lungs, and even vomiting during physical activity; coughing up phlegm and blood

A physical exam and pulmonary function test reveals that Andrea's smoking has already affected her health. What kind of damage, and how?

lung blockage; lung inflammation and burning from the heat of smoke and its chemicals; cold hands and feet due to blood vessel constriction; higher resting heart rate (note: if pregnant, smoking also causes the unborn baby’s heart to beat faster)

Tyra names some ways that smoking also affects your appearance. What are they? What are some others?

yellow teeth; wrinkles; bad complexion; dull hair; bad breath; yellow skin from where you hold a cigarette; ashes can burn holes in clothing

Based on what Andrea’s doctor tells her, name the different elements in a cigarette and how they affect the body.

as the burning tobacco turns to smoke, it breaks down into tar and chemicals; tar, which is a cancer-causing ingredient, gets deposited (mouth, larynx, throat, lungs) as it’s inhaled; the chemicals first burn and irritate the inside of the lungs, then get absorbed from there into every part of your body, e.g. heart, stomach, bloodstream; one of these chemicals is nicotine, which especially affects the brain and causes the addiction; heat from the smoke itself also burns the inside of the lungs

Is it better to smoke "light" or "low tar" cigarettes?

no, because you end up smoking more often and inhale more deeply to get the same amount of nicotine; the hot smoke causes the same damage to lungs

Is marijuana "safer" to smoke?

no; again, the smoke burns the inside of the lungs and deposits tar

Pam developed emphysema from smoking when she was only twenty-four. What is emphysema and how has it affected her?

emphysema occurs when the inside of a lung is so scarred from smoking, the lung tissue breaks down and loses its ability to expand and contract; the result is a constantly shrinking lung capacity; because of her emphysema, Pam had part of a lung removed and is always short of breath; she must take medication for life that causes her to gain weight and look older

What are some of the other effects that smoking can have on people in their twenties?

diminished sense of smell and taste; chronic bronchitis; lung and larynx cancer

Is the damage to Andrea’s and other young smokers’ lungs reversible?

it depends on how long and how much you've smoked; starting young can cause more damage because the lungs are still developing; the sooner you quit, the more likely the damage is reversible; if she quits now, Andrea should feel better in a few months

You could say that the former Lucky Strike model is now in an ironic situation. Why?

she was a role model of an active, healthy, glamorous woman; now, her larynx was removed due to throat cancer and she breathes through an opening in her neck; she is also fighting lung cancer

ACTIVITY:

As a class, discuss some of the common myths surrounding smoking. What are some things students might be hearing from family members who smoke? If they don't smoke, what do they hear their friends saying? If they do smoke, what are they telling themselves?

ACTIVITY:

The Centers for Disease Control and Prevention estimate that each smoked cigarette takes seven minutes from a smokers' life. As a class, calculate the number of years already lost by an 18-year-old who has been smoking half a pack per day, for a year. What about for two years? What about smoking just five cigarettes a day since the age fourteen?

ACTIVITY:

There are many medical situations that mix very dangerously with smoking, such as being pregnant, taking birth control pills, or having asthma. Ask students to divide into research groups and see how many they can find, along with related facts, then share their results with the class.

ACTIVITY

Students may believe that cigars or chewing tobacco are less dangerous. As a class, research the health risks specifically associated with these, e.g. diseases of the mouth such as larynx, mouth and tongue cancer.

SECTION TWO

KICKING THE HABIT

A group of six teens from Stuyvesant High School describe how and why they took up smoking, why they realized they wanted to quit, and offer Andrea some coping tricks and tips that work for them. Dr. Jamie Ostroff of Memorial Sloan-Kettering Cancer Center describes how teens can tell that they're addicted, and provides additional advice on how to quit.

How long does it take to get addicted to nicotine?

anywhere from a few weeks to a few months, it depends on an individual’s susceptibility; nicotine can be as addictive as alcohol, cocaine or heroin

According to Dr. Ostroff, what are some questions you can ask yourself to see if you're addicted to cigarettes?

do I smoke more in the morning?; would that morning cigarette be hardest to give up?; would I still smoke if I were really sick?; Is it hard to be in places where smoking is banned?

What made these teens want to quit or cut down on cigarettes?

health concerns; affecting activities they enjoyed like singing and athletics; pressure from friends and girlfriends/boyfriends

According to these teens, what were the downsides of smoking cigarettes?

difficult to go to non-smoking places like movies; feeling that the cigarettes own you and you have no control; they affect your judgement; cost too much money

What were some of the first withdrawal symptoms these teens felt after quitting?

nervous; short temper; headaches and muscle aches

These teens are committed to quitting smoking, but they still find themselves in situations where they want a cigarette. What are some of these situations?

school exams; family arguments; feeling stressed or tired; activities where they used to smoke; being around friends with whom they used to smoke

NOTE: The following could be in a separate section for tips on quitting, including the 4 D's (Deep breathe, drink water, divert attention, delay reaching for that cigarette—the urge will pass)

What are some of the survival tips they gave Andrea for quitting?

set a quit date; don't pick a stressful time to quit; cut down gradually before that date to reduce withdrawal symptoms; put yourself in situations where you absolutely can't smoke; when you want a cigarette, think through what it's doing to you and why you chose to quit; have plenty of gum and candy on hand; tell everyone you're quitting so they can support you; do things you enjoy like exercise, listening to music, or talking on the phone until the urge passes

What happens if you quit, then give in and start smoking again? Does this mean you're a failure and will never be able to quit?

no; it's okay because quitting can take practice; it'll be easier to quit the next time

 

ACTIVITY:

As a class, calculate how much money is spent monthly by someone who smokes half a pack each day, given that the average cost of a cigarette pack is $2.50. Ask students to name what they could buy with that money. Calculate higher numbers, such as over the course of a year, ten years, or a lifetime smoking habit of fifty years.

ACTIVITY:

Create a list of other health or addiction related questions that concern the students, and have them research for report. (See Resources section)

ACTIVITY:

Create a list of other activities or images besides smoking that the students find "cool", e.g. having a great personal style, playing a sport well, showing artistic or performing skills.

ACTIVITY:

Create a list of some of the more indirect downsides to smoking. For example, if it affects your athletic performance, you could lose a scholarship to college; or if someone is interested in asking you out, they may get turned off by the fact that you smoke.

ACTIVITY:

If possible, identify students who admit that they smoke and would like to quit. Find one or more to volunteer to be the "Class Butt-Kickers". As a class, help them set a quit date, find ways to avoid the urge to smoke, and provide ongoing support. Ask the them to keep a diary of the experience, if willing, to share with the class.

ACTIVITY:

Research local smoking cessation programs available to teens. If none are available, ask the school health counselor to start one.

SECTION THREE

TEENS AS TARGETS: THE IMPACT OF THE MEDIA

Bill Novelli, President of the Campaign for Tobacco-Free Kids, explains how and why tobacco companies target teen consumers. A group of teen activists and peer educators (S.H.O.C.K) recount how their testimony before Mayor Giuliani helped ban cigarette billboards and advertising within one-thousand feet of New York City schools. Young singer-songwriter Leslie Nuchow explains why she refused to be part of a CD produced and marketed by Virginia Slims, designed to help sell smoking to music fans. Patrick Reynolds, grandson of tobacco magnate R. J. Reynolds, reveals that cigarette packaging doesn't list ingredients because they include many known poisons.

 

Why are teens such an important group of people to tobacco companies?

they're losing approximately 3,000 customers every day to quitting, death, and disease; they need to replace them with young smokers who will pay for their habit for years to come; if teens don’t start by 19 to 21, they are unlikely to become smokers; teens are vulnerable and buy into images of acceptance, popularity, fun; teens like to look older and feel independent

How do we know these campaigns are working?

Bill Novelli points out that the three most advertised brands—Camel, Marlboro, and Newport – are the 3 most popular with teens

According to Bill, what strategies do tobacco companies use to target teens?

billboards near schools and playgrounds; advertising in places teens hang out like sports arenas and local stores; offering promotional items like T-shirts and baseball caps; offering "frequent buyer" programs as incentive to smoke

What are some of the themes used in cigarette ad campaigns directed at teens?

love, rebelliousness; adventure; sex; "natural" or "no additives" claims which seem healthier, but are just as harmful

How do tobacco companies get "free" advertising in the media?

smoking in movies, TV, and music videos; popular actors and musicians are regularly seen smoking and appear "cool"; fashion models who smoke help promote the image that it makes you beautiful and popular

Patrick Reynolds says people would be horrified if they knew what was really in cigarettes? What are some of these surprising ingredients and why would tobacco companies want to hide them?

acetic acid, also found in hair dyes; acetone, which is used in nail polish remover; arsenic, the main ingredient in rat poison; other chemicals include ammonia, benzine (used in rubber cement), styrene, phenol, nickel, hydrogen cyanide, formaldehyde, cadmium, tulene, vinyl chloride

 

Why did Leslie refuse to be part of the "Woman Thing" CD?

she stopped smoking because it affected her voice; she is angry that they’re disguising a smoking promotion as a music promotion, and doesn't want her music to be used to get underage smokers; she has also started a group to picket the "Woman Thing" concerts

(NOTE: This is related to an activity listed below)

How can teens fight back?

get angry and don't allow yourself to be manipulated into smoking; start letter-writing campaigns to city councils to get advertising removed around schools and playgrounds; write to the media e.g. magazines that carry tobacco ads, movie companies that portray young smokers, as well as actors and models who smoke

 

ACTIVITY:

Have students collect cigarette ads from magazines and examine the images in the ads. What are the advertisers trying to trick you into believing are the good things about smoking? Do the models look young and healthy? Are they glamorous or athletic? Do these answers fit in with what students know about the effects of cigarette smoking? Explain that tobacco advertisers claim they don't target young people, insisting that they never use models under twenty-five, and don't put smokers in athletic-looking poses. Ask your students if they think these claims are true. Put all your ads together and make a collage or mural. Use sticky notes to highlight the real truth about the advertisements.

ACTIVITY:

Have a group of students visit an elementary school class, such as third or fourth grade, and make a presentation on the hazards of smoking, and the images portrayed in cigarette ads. Ask your students to write about their experience.

ACTIVITY:

Ask students to create anti-tobacco stickers to put on the covers of magazines that contain cigarette ads. For instance: "Warning: Cigarette ads may be hazardous to your sense of reality". "Warning: Smoking is neither glamorous nor cool. It makes people sick!" Then have students ask doctors, dentists, and hospitals if they can put these stickers on magazines in their waiting rooms.

ACTIVITY:

Ask each student to choose their own target of a written request against smoking. For example, a local elected official, a celebrity who smokes and sets a bad example, a favorite magazine that contains cigarette ads. Display the letters in school and ask students to share any responses they get.

ACTIVITY:

Ask each student to create their own "true" smoking ad, to send the real message about the effects of smoking to kids and adults. Seek permission to display ads in school, a public library, or a local government building. Hold a contest to choose the best one and send the winning entry to a local newspaper.

ACTIVITY:

Bill Novelli refers to documents that have recently been released to the public, detailing tobacco companies’ strategies to specifically target teens. Break the class into groups to research these documents or articles about them in libraries, on the Internet, from anti-smoking organizations. Review and discuss them.

ACTIVITY:

As a class, research the laws in different cities and states banning smoking from public places. Discuss how students feel about these laws. Are they fair? Do you think they're working to make people smoke less? Is there really a changing attitude towards smokers in this country?

NOTE: For other activities, contact the Center for Disease Control and the Campaign for Tobacco-Free Kids (See Resources)

SELECTED RESOURCES

Organizations

Centers for Disease Control

Office on Smoking and Health Public Information

(800)n 232-1311

www.cdc.gov/tobacco

Campaign for Tobacco-Free Kids

1707 L Street, NW, Suite 800

Washington, DC 20036

(202) 296-5469

www.tobaccofreekids.org

American Cancer Society

1599 Clifton Road

Atlanta, GA 30329

(800) 227-2345

American Heart Association

7320 Greenville Avenue

Dallas, TX 75321

(800) 242-8721

American Lung Association

1740 Broadway, 16th Floor

New York, NY 10019

(800) 586-4872

National Cancer Institute

Cancer Information Service

Johns Hopkins Oncology Center

550 N. Broadway, Suite 307

Baltimore, MD 21205

(800) 4-CANCER

Americans for Non-Smokers’ Rights

2530 San Pablo Avenue, Suite J

Berkeley, CA 94702

(510) 841-3032

www.no-smoke.org

National Association of County and City Health Officials

1100 17th Street, Second Floor

Washington, DC 20036

Phone: (202) 783-5550

Fax (202) 783-1583

E-mail: info@NACCHO.org

www.naccho.org

Girls Incorporated

441 W. Michigan Street

Indianapolis, IN 46707-3787

(317) 634-3024

www.girlsinc.org/sos

Girl Scouts of the USA

420 5th Avenue

New York, NY 10018

(212) 852-8000

www.girlscouts.org

American Academy of Pediatrics

Division of Public Education

141 Northwest Pt. Blvd.

Elk Grove, IL 60007

(800) 433-9106 ext. 7873

On the World Wide Web

Center for Disease Control Office on Smoking Information Resources

www.cdc.gov/tobacco

Contains the latest scientific studies and educational materials on tobacco use by adults and youth, as well as information on secondhand smoke and how to quit using tobacco. The site also contains information about the Surgeon General’s Reports on tobacco use, TIPS4Teens, TIPS4Kids, Media Campaign Resources, Smoking and Health Database, and weekly citations of recently published, tobacco-related articles from scientific, technical, and behavioral literature.

Campaign for Tobacco-Free Kids

www.tobaccofreekids.org

Features the Campaign’s special events, daily news bulletin, updates on legislation and lawsuits, facts, research, interactive calendar, and more.

The American Lung Society’s Great American Smokeout

www.cancer.org/smokeout

Get Outraged

Facts and news about tobacco issues.

www.getoutraged.com

The Real Scoop on Tobacco

itdc.sbcss.k12.ca.us/curriculum/tobacco.html

Florida Pilot Program on Tobacco Control

Features playable video of PSA airing statewide

www.wholetruth.com

New Teen Health Website (Washington State)

weber.u.washington.edu/~ecttp

www.cquest.com/LeskoBrothers.html

A great site about two young brothers who campaigned to rid their community of tobacco vending machines.

www.tobacco.org

An informative and comprehensive site, addressing virtually every subject relating to tobacco issues.

Smokescreen Action Network

www.smokescreen.org

Includes tobacco-related news, an "ask the experts" section, a database of tobacco control resources, and ready-made e-mails to send to lawmakers regarding proposed legislation.

Stop Teenage Addiction to Tobacco

www.stat.org

Features interesting and updated information about tobacco, fun activities to get young people involved in tobacco prevention, and a way to be heard nationally about tobacco issues.