Teens and tobacco quiz: What do you know?

Very few people begin smoking as adults. In fact, nearly 90 percent of adults who smoke took up the habit before they turned 19.

Most teen smokers start in early to mid-adolescence, but a startling 25 percent of U.S. adolescents have smoked an entire cigarette by the age of 13. The earlier children begin smoking, the more likely they are to continue smoking. That's why it's so important to begin talking to children about smoking early, when they are in grade school.

Adolescent girls often start smoking in an effort to lose weight, while boys rarely start smoking for this reason. Boys and girls both start smoking for the following reasons:

• Curiosity about how the drug will affect them
• Desire to fit in with the smoking crowd
• Wish to get rid of bad feelings
• Need to rebel

Bidis appeal to teens because of their candy flavor and exotic look. They're available in chocolate, vanilla, cherry, mint, licorice, menthol and mango flavors. Bidis are made of shredded tobacco that's rolled in dried leaves of tendu, a broad-leafed plant native to India. They are tied at the end with string. Imported from Indonesia, kreteks contain a mixture of tobacco and cloves. Available at many specialty tobacco shops and even some health food stores, bidis and kreteks both deliver higher concentrations of nicotine, carbon monoxide and tar than conventional cigarettes do.

Teens are more likely to begin and continue smoking if their friends, siblings or parents smoke. This underscores the role of peer pressure and parental example in creating the initial atmosphere that leads to nicotine addiction.

Smokeless tobacco contains 28 cancer-causing agents, as well as nicotine — the addictive ingredient in cigarettes. In fact, an average "dip" of smokeless tobacco delivers as much nicotine as several cigarettes do. The product is designed to be placed between the cheek and gum, where users then suck on it and spit out the juices. That's why it's also called "spit" tobacco. Smokeless tobacco can cause cancer in the mouth and other parts of the body. It can also result in stained teeth, bleeding gums and mouth sores that won't heal.

An adolescent can become addicted to nicotine at a lower regular dose than it takes for an adult to become addicted. Teenagers who smoke just one cigarette a day may have withdrawal symptoms when they try to quit. Adolescent girls become addicted more quickly than boys do.

In a U.S. survey of adolescent smokers, 70 percent said that most people who smoked for a few years would become addicted and be unable to stop. But most of these kids obviously felt that they were somehow immune to dependency, unlike "most people." Sixty percent of this same group of adolescents believed that they would be able to quit smoking if they wanted to, even if they had been smoking for a few years.

While only three out of 100 high-school smokers think they will still be smoking in five years, studies show that 60 out of 100 will still be smoking seven or eight years later.

Seventy percent of adolescent smokers wish they had never started. Two-thirds have made at least one unsuccessful attempt to quit.