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Parents are sometimes surprised to find that they have as many questions about raising teens as they had when they were raising toddlers. Some of the hardest questions concern teens' risk-taking behavior--using drugs, for example.

You are not alone. Most adult smokers started before age 18. Each day more than 4,000 kids try their first cigarette and more than 2,000 teens under 18 become new, regular smokers. This means there are more than 730,000 new, underage daily smokers each year. Of these, half will prematurely die from their addiction.

Here are some steps you can take to help your daughter stop smoking. If you smoke, quit. This will send a powerful message and strongly influence her to stop. Know your facts. If she tells you, "Everyone is doing it," respond by saying that 78 percent of high school kids do not smoke. Stress the immediate negative effects smoking cigarettes has on her appearance and general health: irritated eyes and throat; bad breath; clothes that smell like cigarettes; dull skin and hair; yellowed, brittle nails; tooth decay; and decreased physical fitness. Other harmful effects caused by cigarette smoking to bring to her attention: increased heartbeat and blood pressure and respiratory problems, such as frequent chest colds and bronchitis, as well as the higher risk of osteoporosis, heart disease, cancer, stroke, emphysema and other health problems later in life. If she says she can quit anytime she wants, ask her to show you so by staying smoke-free for 30 days.

Encourage your daughter to become involved in various sports. Studies show that smoking decreases substantially with an increase in the number of sports played. Athletics also help prevent weight gain that sometimes happens when a person quits smoking. If your child is seeking work, insist that she work only in a smoke-free workplace.

Cognitive behavioral counseling, in which a therapist explores thought patterns that lead to smoking, can be effective in helping some teens quit. Some school-based programs, such as "Towards No Tobacco," also are effective. Studies show that the nicotine patch used in conjunction with group counseling is effective in helping highly addicted teenagers stop smoking. Patches should be prescribed by a health care professional. Discuss your options with your pediatrician or other health care professional to learn what options (medical and non-medical alike) are available to help younger children quit smoking.

--Eric T. Moolchan, MD Clinical Investigator and Director Teen Tobacco Addiction Research Clinic National Institute on Drug Abuse, National Institutes of Health Baltimore, MD

2. Most of my daughter's friends smoke marijuana, and I worry that she will begin to do so as well. What can I do?

You should encourage your daughter to join activities that do not promote drug use, like after-school sports clubs. However, you also need to be realistic. It is quite possible that your daughter is already smoking marijuana. It is hard for teens to resist drugs when all of their friends are high. Initiate an open conversation with her about drug use, in a relaxed environment. It is best to avoid a "we have to talk" approach. Be straightforward, not confrontational. If you know your daughter's friends' parents, you might consider approaching them with your concerns--working out an intervention together may help.

Tell your daughter you love her and are concerned she may be using drugs. Tell her why you're concerned and describe some of the dangers, such as impaired memory; probability of her grades dropping in school; and inability to do things that require concentration and coordination, such as driving a car--so you won't be letting her drive yours, if she's using. You also can mention that smoking marijuana increases risk for cancer and for fertility problems in later years. In addition to all that, it is an illegal substance.

Let her know you're aware of peer pressure and that taking drugs may seem like the right thing to do, but there are serious consequences. Be sure to talk about specific ways to say no. Ask questions and listen carefully without making judgments. Educate yourself as much as possible about drugs so that you can talk regularly with her and provide her with accurate, current information. The Internet is a good place to start. You may want to visit the following Web sites to learn more:

•	Drug Free America Foundation: www.dfaf.org
•	National Institute on Drug Abuse: www.nida.nih.gov
•	Partnership for a Drug-Free American: www.drugfree.org and the
•	American Academy of Pediatrics: www.aap.org.

--Adelaide Robb, MD Medical Director of the Adolescent Inpatient Psychiatry Unit Children's National Medical Center Washington, DC

3. Is a certain amount of experimentation a natural part of adolescent development? How can I make my kids less likely to use drugs?

Experimentation is certainly a part of growing up, but it is difficult to know which teens will experiment and quit and which teens will continue to use and develop serious problems with drugs. There are a number of factors that influence drug use, such as genetic predisposition, family behaviors, circle of friends and drug availability. Parents can play a big role, however, in helping teens avoid experimenting with drugs. For example, research suggests that children who share at least five meals per week with their parents are less likely to use drugs.

Early awareness of behaviors that are risk factors for drug abuse should become part of every parent's preventive strategy for keeping kids drug-free. In preschool, behaviors such as aggression and poor social skills may be risk factors for later drug use and deserve special attention. In elementary school, aggression is also a warning sign, as is academic failure.

Prevention should focus on improving academic performance and social and emotional awareness. In middle and high school, prevention should focus on increasing academic performance and social competence through good study habits, peer relationships and communication. In other words, nurturing your teens' strengths and helping them succeed academically and socially will help them avoid problem drug use.

--Eric T. Moolchan, MD Clinical Investigator and Director Teen Tobacco Addiction Research Clinic National Institute on Drug Abuse, National Institutes of Health Baltimore, MD

4. What drug treatment programs are most effective?

There are many drug treatment programs available, and it is important to select one that is most appropriate for your child's particular needs. Research shows that group settings are more effective for teens than individual therapy, because they provide teens with feedback from peers, rather than from an adult authority figure, who is not using drugs. It would be hard for any teen to forget when a peer says something like, "Taking drugs was the dumbest thing I ever did. I lost a year of my life, because I was so wasted. I hardly remember anything about 10th grade."

Twelve-step programs, like Alateen, for alcohol abusers, and Narcotics Anonymous, for substance abusers, are very effective because of the peer support. Remember, though, that often there are underlying mental health conditions, such as depression and attention deficit hyperactivity disorder, which lead adolescents to use drugs in the first place. These conditions must be treated along with the substance abuse problem. It's best to consult with your pediatrician or another health care professional before deciding what's best for your teen's overall physical and mental health.

--Adelaide Robb, MD Medical Director of the Adolescent Inpatient Psychiatry Unit Children's National Medical Center Washington, DC

5. I smoked pot when I was younger. How should I respond when my children ask me whether I have ever used drugs?

Be honest. Tell them why you did it, and why it was the wrong thing to do. You can tell them that you began smoking pot to "fit in," to feel accepted, but you soon learned about the negative consequences. Smoking pot can cause impaired memory, slowed reaction time and the inability to perform tasks that require concentration and coordination, such as driving a car. Make sure your children know that this means pot users are prone to accidents, and their grades generally go down, because it is hard to focus on work and to retain information.

There are physiological effects caused by smoking pot as well, such as dry mouth and throat, increased heart rate, chest colds and bronchitis. It also increases chances of developing cancer. According to some studies, smoking one joint is equivalent to smoking five tobacco cigarettes, in terms of exposure to cancer-causing chemicals. Marijuana also has an effect on a person's reproductive system: it can lower men's sperm counts and interfere with women's menstrual cycles, causing fertility problems in later years.

--Adelaide Robb, MD Medical Director of the Adolescent Inpatient Psychiatry Unit Children's National Medical Center Washington, DC

6. Is it okay if my child drinks alcohol at home?

There is a common misperception that it is okay for a child to drink alcohol at home. However, there is no data to support this, and I personally don't think it should be allowed, except for very small amounts during an occasional religious ceremony or for a celebration. Even in those circumstances, parents need to be present. Young children are especially vulnerable to the effects of alcohol. It can cause distorted vision, hearing and coordination and alter perceptions and emotions.

The way parents handle alcohol helps shape a child's attitude and behavior. As a parent, you can set a good example if you:

•	Always drive sober.
•	Use coping techniques--not alcohol--to deal with problems, stress or anger.
•	Demonstrate you can have fun and be social without alcohol.
•	Do not allow teens to attend parties where alcohol is served or there is no adult supervision.
•	Do not serve, or allow anyone to bring, alcohol to your teen's parties. (Parents are legally liable for minors' consumption of alcohol in their home.)
•	Talk with your children about alcohol, tobacco and other drug use.

--Charles Irwin, Jr., MD, FASM Editor-In-Chief, Journal of Adolescent Health Professor of Pediatrics Director of the Division of Adolescent Medicine University of California, San Francisco San Francisco, CA