Decline in teenage smoking with rise in mobile phone ownership: hypothesis
BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7269.1155 (Published 04 November 2000) Cite this as: BMJ 2000;321:1155
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Dear Editor - I read with great interest the letter by Ann Charton
and Clive Bates [1], where they advance an interesting hypothesis that
mobile phone ownership can be responsible for the current decline in teen-
age smoking in the UK, by competing with cigarettes on youths' interest
and pocket.
Surely, studies have shown that smoking provides a variety of
social utilities to youths that could be compared to those of mobile
phones such as self-image, sociability, peer bonding, and adult aspiration
[2]. However, my problem with the advanced hypothesis is that the
evolutionary story of teen smoking is not that "in the beginning there was
smoking and then came mobile phones". A lot of teen attractions appeared
over the years, that share with smoking some of the above-mentioned
functions and could therefore, according to the Charlton and Bates
hypothesis, compete with smoking for youths' spare cash, but they did not.
To name some; rock music, rap music, alcoholic drinks, motorcycles,
computer games etc. All these trends contain elements of self-identity,
rebellion, peer bonding, but some of them also contain an element
particularly alluring for youths that mobile phones lacks; that is risk-
taking. In fact studies have shown that teen smoking is associated with
other risky behaviors such as alcohol drinking and drug use [2].
It is conceivable that all these attractions interact in a complex way
with smoking among teens, which is further complicated by the intricacy of
attitude and behavioral dynamics of teens' maturity process and between
genders. We have shown for example, that factors associated female smoking
among high school students in Aleppo-Syria were different from those of
males' [3]. In the same study we found also, that a substantial proportion
of teens in our society do not buy the cigarettes they smoke. Of course
our findings may not be applicable to British youths, but they point, as
well as many others, at the complexity of teens' smoking that defies a
simple explanation.
Having said that the suggested relation between mobile phones and teen
smoking is surely an interesting lead, that deserves further exploration.
Wasim Maziak PhD
Georg Forster Fellow
Institute of Epidemiology and Social Medicine
References:
1. Charlton A, Bates C. Decline in teenage smoking with rise of
mobile phone ownership: hypothesis [letter]. BMJ 2000;321:1155.
2. Preventing tobacco use among young people: a report of the Surgeon
General. Atlanta, GA: US Department of Health and Human Services, Public
Health Service, Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion, Office on
Smoking and Health, 1994.
3. Maziak W, Mzayek F. Smoking among high school students in Aleppo-
Syria [Abstract]. Am J Respir Crit Care Med 1999;159(3): A488.
Competing interests: No competing interests
Interesting hypothesis. It is a pity that the authors do not provide
prospective within-person data on smoking and mobile phone ownership.
Comparing representative samples of smoking and non-smoking teenagers on
mobile phone ownership would be a feasible alternative to test the
hypothesis.
Competing interests: No competing interests
EDITOR - My wife (a consultant orthopaedic surgeon) usually avoids
letting me read the BMJ because I tend to harumph at lot about the quality
of the statistical argument in many articles. (I advise companies on the
effective use of their customer information for a living).
But I sneaked a look at last week's and did indeed harumph about the
letter from Anne Charlton and Clive Bates. Their use of data was
breathtaking in its inaccuracy.
For a start, the chart has no data points before 1996, so we have no
way of judging how dramatic the downturn in teenage smoking has been.
But more important, the chart shows clearly that teenage smoking was on a
declining trend before the sharp rise in mobile phone ownership. And, even worse, at the point where phone ownnership sharply increases,
the decline in smoking actually levels off.
A clear case of not letting the facts get in the way of an
interesting hypothesis, and even more regretable given that the letter
caught the national headlines. This sad
misuse of numbers is a great deal worse - because it is so obvious - than
the more technical statistical liberties found in BMJ articles that are the
usual cause of my breakfast harumphing!
Trevor Jones
Managing Director
Marketing Databasics,
Links House,
15 Links Place,
Edinburgh
Competing interests: No competing interests
I am afraid that the author of "Then Everythings Addictive" has
missed the point of the original letter.
It is not being suggested that mobile phones are providing an
alternative addiction to smoking. Merely that they may be replacing it as
a component of teenage lifestyle.
This change could be taking place anywhere on the road to smoking,
from factors encouraging teenagers to start smoking in the first place, to
interruptin maintenance factords in smoking by reducing their ability to
pay for tobbacco.
Competing interests: No competing interests
The prevalence of young smokers in Switzerland between the ages 15 and 24 has increased disproportionately between 1992 and 1997. The number of mobile phone subscribers has increased from 215,000 in 1992 to 1,044,000 in 1997. Even though I do not have the specific numbers for the age group 15 to 24 year olds, it is quite likely that there was at least a proportional, if not even more rapid, growth in this age group. I agree that this question can only be resolved through a prospective study in which other known promoters and demoters of smoking in various countries are considered together with mobile phone use among youth.
1992 1997
******************************************
smoker overall (1) 30.1% 32.7%
smoker 15-24 years 31% 43%
mobile phones (2) 215,000 1,004,000
******************************************
(1)Swiss National Health Survey 1997. Swiss Federal Office of Statistics ( www.statistik.admin.ch/news/pm/dp98108.htm downloaded 8 Nov. 2000)
(2)Telecommunication Statistics 2000-1. Swiss Telecommunications Market: Evolution of the infrastructure ( www.bakom.ch/ger/subsubpage/docs/1366/#Top downloaded 8 Nov. 2000)
Competing interests: 1992 1997******************************************smoker overall (1) 30.1% 32.7%smoker 15-24 years 31% 43%mobile phones (2) 215,000 1,004,000******************************************
I find this assessment ludicrous. This would then lead to the idea
that a business person who appreciates and utilizes their PDA is obviously
addicted to the device. Or an individual who drives a sporty car only
does so to improve their image.
I find assessments and statements such as this misleading and erroneously
persuading consumers against purchases.
Let's get rid of Barbie and GI Joe now too because they represent
adult ideals and result in peer pressure to have the most dolls / action
figures.
Most of us grew up just fine with the same types of influences and
pressures. Let kids be kids. Atari didn't kill me it made me want to
design something better, what's wrong with that.
Leave kids alone to decide if they want the phones or not. Leave
parents alone to set the rules for use.
Competing interests: No competing interests
I learnt of this article from a Report in The Indian Express, Mumbai
edition, Nov.3,2000. It was captioned: "Want your kids to quit smoking?
Buy them a mobile phone." Having heard of some controversial reports of
the linkage of use of mobile phones to increased risk to cancer, my
immediate reaction to the report was that "One way or the other we shall
give it (cancer) to you, our profits matter most."
I was prompted to read the article in the BMJ and feel that though
it is an interesting hypothesis, it must be explored in a holistic manner
keeping the other medical and social consequences of varied extents of
mobile phone use, and not in isolation with smoking behavior. Else it
could give misleading publicity to a device which is itself not completely
safe.
Gurmeet Hans
Competing interests: No competing interests
The hypothesis of a beneficial effect of mobile phones on adolescents’ smoking attitudes is appealing, and the explanations suggested by Charlton and Bates (1) very attractive. Italians are leaders in the European Union as consumers of mobile phones, so that the influences of this particular social habit on teenage behaviour could be studied appropriately in our country. However, data from ISTAT (the Italian Institute for Statistics) do not suggest a decrease in smoking prevalence in the age-range 15-24 in Italy, as shown in the Table:
Percentage of smokers amongst Italian youngsters aged 15-24 in the years 1995 and 1998* _____________________ 1995 1998 _____________________ Males 27.7% 26.2% Females 12.7% 15.4% --------------------- *source: ISTAT
On the contrary, while smokers amongst boys appears to be stable, smoking apparently has been growing in girls in the period 1995 through 1998 (2).
Only a survey intended specifically to study the possible correlations between smoking and mobile phone usage will be able to verify this interesting hypothesis.
Giovanni Invernizzi (Head, Tobacco Control Team, Respiratory Branch, SIMG-Italian College of GPs, Milan, Italy)
Roberto Boffi and Roberto Mazza (Smoke-free Institute, National Cancer Institute, Milan, Italy)
Paolo Paredi (National Heart and Lung Institute, London, UK)
References:
1)Charlton A, Bates C. Decline in teenage smoking with rise in mobile phone ownership: hypothesis. BMJ 2000;321:1155.
2)Annuario Statistico Italiano, 1999.
Correspondence:
Dr. Giovanni Invernizzi,
via Della Michela, 17,
23020 Prata Camportaccio,
Italy
e-mail: ginverni@clavis.it
Competing interests: Percentage of smokers amongstItalian youngsters aged 15-24in the years 1995 and 1998*_____________________ 1995 1998_____________________Males 27.7% 26.2%Females 12.7% 15.4%---------------------*source: ISTAT
Dear Sir,
To analyse if this effects are seen in other countries too, I suggest to
start a collaborative study to compare national smoking habits and mobile
telephone use. Anyone who might be intersted to join such a study-group is
invited to contact me by e-mail.
Yours
Helmut Brand
Competing interests: No competing interests
Thank You
Hello there my name is Chris and i'm an 18 yo receptionist from
Australia and whist completing a task for one of my tertiary studies i
stumbeled accross this article and used information from your hypothosesis
for the assessment and received a distinction. I very much agree with this
hypothesis and as the clock turns hope that your research becomes
recognised for more than a hypothesis.
As i read it all came together and made sense so i went and brought
my 13 yo brother a phone in the hope that it would keep him away from
smoking and drugs and it has worked wonders and he's not got a job and has
in my view turned his life around as he was pointing in the wrong
direction.
In conclusion I greatly agree with your Hypothesis and hope that you
are acknowledged for the fine discovery that you have made
Thank You once again
A strong beleiver in the hypothesis
Chris Isaac
Competing interests:
None declared
Competing interests: No competing interests