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DURHAM, N.C. -- It is hard to reduce cigarette smoking rates when a new smoker is born for each smoker who quits or passes away, but researchers at Duke University Medical Center are doing their best to snuff the trend.

According to the American Cancer Society, the smoking rate for people older than 18 dropped from 42 percent in 1965 to just 25 percent in 1990, but high school students have made up the difference. In 1991, 27.5 percent of high school students had smoked in the past month, while by 1995 that number had jumped to 36.4 percent.

"Our cessation rates are pretty good," said Colleen McBride, director of the Cancer Prevention, Detection and Control Program at Duke Comprehensive Cancer Center. "The real problem is that uptake rates among teen-agers are way too high."

"We're finding that teenagers have pretty high rates of smoking," says Isaac Lipkus, associate research professor of psychiatry and behavioral sciences. "The question is how do we get those who smoke to quit? We know very little about what the best technique is to get them to quit smoking."

So Lipkus is leading a study to learn more. In this study, teenagers are intercepted in shopping malls, and those who say they have smoked cigarettes - even one puff - in the previous 30 days are asked if Duke researchers can call them to explain the study. After discussing the study, teens who enroll receive self-help booklets on smoking cessation and a videotape about smoking. Half of the study participants also are called for follow-up counseling about smoking cessation.

More than 1,600 teens have been approached in four states, and so far 167 teenagers between the ages of 15 and 18 have enrolled in the study, which will wrap up in November 2001. Lipkus says he hopes this study will determine whether teens receiving telephone counseling in addition to self-help booklets have more success in quitting.

"The fact is the vast majority of people start smoking when they're adolescents, however, little is known about nicotine effects during adolescence," said Ed Levin, director of the integrated toxicology program at Duke. "We do know that the earlier you start smoking, the more likely you are to be a lifelong smoker."

To learn more about how nicotine affects young people, Levin is turning to rats. In one study, he's investigating whether rats allowed to self-administer nicotine when young will as adults choose nicotine more often than other rats. This study and others to come may lead to understanding the brain mechanism underlying addiction in adolescent rats, he said.

Understanding the addiction may be the first step in addressing it. If adolescent animals with access to nicotine are more addicted as adults, it supports what many already believe: that smoking prevention or intervention in teens could help reduce the percentage of the population addicted to smoking.

Theodore Slotkin, a professor of pharmacology and cancer biology at Duke who has been examining nicotine's effects in animals for 25 years, recently began looking at adolescent exposure in addition to his long-standing interest in fetal exposure to nicotine.

It's been known for some time that smoking during pregnancy can lead to numerous problems with the baby, including low birth weight, behavioral problems, brain damage and an increased risk of Sudden Infant Death Syndrome, or SIDS. Now, in five articles recently published in the journal Brain Research, Slotkin and his colleagues have reported that rat studies show nicotine's ability to negatively impact brain function and behavioral measures extends into adolescence. They also found that nicotine exposure in adolescent rats negatively affected cardiac function. The effects of nicotine in the rats persisted for months after nicotine was taken away, indicating that adolescent nicotine exposure might result in lasting damage, says Slotkin.

"We need to get kids to stop smoking as soon as possible - while they're still kids," said McBride.

According to the American Cancer Society, tobacco use is responsible for almost one out of every five deaths in the United States. Cigarette smoking causes 87 percent of lung cancers and accounts for at least 30 percent of all cancer deaths. It is a major cause of heart disease and is associated with cancers of the mouth, pharynx, larynx, esophagus, pancreas, cervix, kidney and bladder. It is also associated with a wide range of conditions, including colds, gastric ulcers, chronic bronchitis, emphysema and cerebrovascular disease.

Nov. 16 is the American Cancer Society's 24th annual Great American Smokeout. To learn more, visit the ACS online at http://www.cancer.org.