Numerous studies confirm that smoking is the most widespread addiction among young people. Although they are often aware of the consequences of smoking, they tend to disconnect those risks from their own smoking experiences. Instead, they overestimate the short-term social benefits they believe smoking brings, such as group belonging, striving for adult behavior, popularity, and the like.

In our country, the first experience with smoking usually occurs at the age of 13. Smoking is one of the greatest health risk factors and can also be a risk factor for alcohol abuse and the use of various illegal substances.
What’s the real issue? Nicotine. Several studies on the effects of nicotine on the developing teenage brain have shown long-term health consequences. It harms concentration, learning ability, mood, impulse control, and more. The list is long.

The most important factors that influence the development of smoking habits in young people are the availability of tobacco and the social environment. Although peer pressure and social status are often mentioned as the main reasons for starting to smoke, research shows that family also plays a significant role—especially if the child frequently spends time in places where people smoke. Youth are more likely to start smoking if family members or close people smoke.

Parents should serve as role models for their children and teach them to make thoughtful decisions about what is good or bad for them, thus equipping their children to independently adopt habits that benefit their health and reject behaviors that harm it. It is essential for parents to help their children build self-confidence, a sense of self-worth, and self-respect so they can resist peer pressure. It’s also important to develop a relationship of trust in which the child can openly talk about their experiences and problems without fear, while parents must also trust their children.

However, it is concerning when parents know that their child smokes and approve of it. According to a survey conducted by the NARKO-NE Association, more than half of students (58.9%) say that their parents are aware they use tobacco products. Parents should be the ones setting clear boundaries to protect their child and, more importantly—they must be role models in adhering to those same boundaries. Parents should not view smoking as a passing phase but should actively participate in preserving their children’s health and preventing harmful habits, as this is primarily their responsibility, and only then a task for the community.

In addition to cigarettes, we must not overlook other nicotine-containing products such as hookahs, electronic cigarettes, vapes, nicotine pouches, and snus.
Hookah smokers usually smoke less frequently but more intensely than cigarette smokers. A hookah session typically lasts between 20 and 90 minutes, which means smokers are exposed to tobacco smoke for longer than during cigarette smoking. Hookah smokers also tend to inhale more deeply into their lungs due to the force required to draw smoke through water. Various analyses have confirmed that both tobacco and herbal hookahs release carbon monoxide (CO) and other toxic substances during combustion, which are known to increase the risk of throat, lung, and oral cancers, as well as cardiovascular diseases. Some studies show that one hookah session is equivalent to smoking a pack of 20 cigarettes. Smoking a cigarette takes about 5–7 minutes with around 8–12 inhalations, whereas a hookah session lasts 20–80 minutes. Don’t forget the questionable hygiene practices in some hookah lounges.

Electronic cigarettes are not a tool for quitting smoking as often claimed, because the vapor mixture users inhale contains nicotine, which is addictive.
Nicotine pouches and snus are products through which nicotine enters the body much faster than from cigarettes. These are smokeless products intended for oral use. Nicotine pouches contain a high percentage of nicotine, with one pouch potentially containing as much nicotine as a pack of cigarettes—meaning they more easily lead to nicotine addiction. An average can of snus contains about 60 milligrams of nicotine, equivalent to three packs of cigarettes. Therefore, snus is not a safe alternative to cigarettes.

These products are proven to be harmful to health, containing thousands of harmful substances, 76 of which are carcinogenic, and the nicotine content makes them addictive.
Manufacturers often promote these products as less harmful or as aids to quit smoking, creating a misleading public perception that these are safer alternatives to cigarettes. Studies show the opposite: that the nicotine in these products is just as addictive as in other tobacco products and causes numerous adverse health effects.
So, while you may wonder whether you’ve quit the addiction, think again—have you just replaced it with another?

Children and young people are significantly exposed to passive smoking, which also has extremely harmful effects on health. According to data from the Public Health Institute of the Federation of Bosnia and Herzegovina, children who spend several hours in a smoke-filled room with multiple smokers or in a closed car with one smoker inhale as many harmful chemicals as if they had smoked ten or more cigarettes themselves. The tobacco smoke released into the air contains higher concentrations of harmful substances than the smoke the smoker inhales. Even after two hours of airing out a smoky room, the concentration of harmful components remains above the permitted level.

When we talk about smoking prevention among young people outside the family environment, knowledge about the harmful effects of smoking is important, but not enough. The key moment is turning that knowledge into attitudes (to know what to avoid, we need to know what is harmful).
The preservation of the health of children and young people should be the top and shared priority of parents, educators, health professionals, and the community as a whole.

Given the constant emergence of new trends—especially in the area of tobacco products, where the tobacco industry constantly seeks ways to circumvent laws and reach young people with ads for “less harmful products”—it is crucial that prevention efforts are not focused solely on bans. Instead, the focus should be on identity-building among young people—developing their own opinions and promoting the values of a healthy life. Only in this way will young people be able to recognize and reject harmful influences from their environment and make decisions that align with their health and long-term well-being.

Azra Halilović

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*Istraživanje o kockanju i korištenju interneta, te navikama konzumiranja duhanskih proizvoda, alkohola i marihuane među djecom i mladima u tri kantona Federacije Bosne i Hercegovine 2024. dostupno je ovdje.