Expert: Ryan Hale - 5/25/2009

Question
My wife and I are very concerned that our son has just
started smoking.  He was a high performance athlete who
just finished his first year in University, but developed
an eating disorder while playing football at University.  
He was in the hospital for treatment and is now in a day
program for treatment of his eating disorder.  He is 3
weeks into a 12 week program and has been smoking for about
two weeks.  He says he is only smoking about 3 cigarettes a
day.  I just want to know why he may have started and how
we can help.  We would like him to stop; it seems he has
replaced one addictive behavior with another.

Answer
It is typical for someone who is going through a treatment program to replace one behavior for another or one addiction for another.  In drug treatment, they even sometimes replace one drug for another and then try to eventually get the person off the new, less damaging drug.

For someone with an eating disorder, there is often a situation of feeling out of control.  If he was in a rigorous academic program and/or a highly drilled football program, he may not have had a lot of control over most aspects of his life (when he went to class, what courses he took, when to sleep in, when to get up early, when or what to eat, etc).  The eating disorder may have come about, in part,  from the highly structured life he was living.  

Also, athletes tend to be the kind of people who are willing to put up with discomfort, to face a challenge, set higher and higher goals and to listen to whatever the coach says will make them better.   If the coach made a comment about needing to be more fit or lose weight, an athlete can take that to the extreme.  I am also concerned that there are others on the team who also have an eating or addictive issue.  It is very rare that this kind of thing happens in isolation.  There is either an environment on the team that supports it, promotes it, or tolerates it, either by commission or omission.  That is to say, they either promote it or know it is happening and let it.  There is also an aspect of these behaviors being a sort of "team building" ritual or part of a bonding experience.  This entire statement is backed up by research and not just my opinion.

It would be wise to see who his friends are on the team (often it is a group within the group), talk to the coach and see what his position is, talk to the athletic director at the University and get their position.  If anyone is not aware of the situation, the potential for it to be bigger than they thought, or not supportive, you may want to see about a transfer to another situation.

The smoking could just be normal college age experimentation, or he could be self-medicating.  He may need to feel SOMETHING that regular life and every day experiences are not providing.  There is the possibility of needing some sort of medication to balance things out in his brain.  

Either way, it's good he is in treatment now, but I would recommend continuing with a mental health therapist to make sure he's getting along ok with everything in his life (relationships, school, the team, new responsibilities, etc).  If the eating disorder is part of a larger issue, the continuing therapy will help.  If the smoking is part of a bigger issue, it will help find that out.

Make sure too, that you as his parents are not expecting him to be living YOUR dreams of him playing football at a high level.  If he feels high pressure to be doing something because of a lot of time or money that you've put in and feels obligated to you, that can be a large part of the problem as well.

I see athletes weekly who insist they are hurt or start behaviors detrimental to their performance so they won't have to live their parents expectations any more.  Think about it... it's a great way to get out of having to perform if you obviously can't perform right?  I'm not saying this is your case but I see it very, very often.

It could be that athletics will make it easier for him to get better, since performance and participation is a good incentive to eat right and be healthy.  Hopefully that is the case.  If I can be of further help please write again.