On any given Friday night, in any South African city, groups of 20-somethings will gather together for a drink in their favourite bar or shebeen. Whether they're students, factory workers or young professionals, they'll be the image of health and fitness, except for one thing — they're still lighting up despite the health warnings.

According to the Department of Health, 23 percent of South African men and seven percent of women aged between 15 to 24 years are smokers — and the rates of smoking daily or ocasionally has increased in young women aged from 15 to 24.

More women are lighting up cigarettes around the world even as the smoking rate declines for men.

Nico-teens

Some blame the billions that cigarette companies spend on marketing each year, including promotions geared towards young adults, teenagers and even children.

Girls are especially influenced by the glamorous images of smokers in movies and TV shows such as Sex and the City, and many of them have heard that smoking can keep them thin.

A 2002 study by the World Health Organisation and US Centres for Disease Control and Prevention found that high school girls who were trying to lose weight were 40 percent more likely to smoke than peers who weren't.

Girls are also swayed by celebrities and models who smoke to stay thin. Smoking among female lead characters in movies nearly tripled from the 1960s to the late 1990s, and tabloids run candid shots of A-listers puffing away.

Supermodel Naomi Campbell once told a reporter: "I never diet. I smoke."

Actress Cheryl Ladd admits she smoked for 23 years to stay thin, and model Gisele Bündchen reportedly gained seven kilograms when she quit.

Such body-image pressures may help explain why many young women start smoking in their teens — even though it's illegal to purchase tobacco products under the age of 18 on South Africa.

In the group aged from 15 to 19, 45 percent of coloured female adolescents smoke, followed by 25 percent of young Indian females, and 16 percent and four percent of white and African female adolescents.

Starting out young

Nicole Rose is a typical smoker. She was a 16-year-old high school student when she took her first puff. Now 27, Rose, has been a daily smoker pretty much ever since.

"I don't have an issue with my smoking at the moment," she says. "The anti-smoking ads don't bother me whatsoever. Even the warnings on the cigarette packs don't bother me."

Rose smokes about three cigarettes a day, but more on the weekends.

"I'm not a morning smoker — I only smoke when I get home from work, unless I’m having an extremely busy day and I'm stressed," she says.

"Then I might have one, but it's more to give myself a break than anything else."

When she's sick, Rose says she won't smoke for a week or more. "I don't think it's a matter of I can't give up; I think it’s more that I don't want to," she admits.

"If I fell pregnant or decided to start a family, I would give up."

In fact, most smokers who fall pregnant continue their habit, according to Anne Jones, chief executive officer of Australian pressure group Action on Smoking and Health.

"I don't plan on smoking for the rest of my life," Rose says. "I like the idea of not being a smoker, but I am comfortable at the moment."

Health risks now

The problem with a philosophy like Rose's, experts say, is twofold. Quitting isn't as easy as young smokers think it will be. And, while they might pigeonhole cancer and heart disease as "something older people get", there are health effects that show up early.

"Smoking is a real problem for young women, right in the here and now, not just later on," warns cancer expert Professor Ian Olver.

"At this age it has the potential to cause problems with their menstrual cycle and complications with pregnancy. It's well documented that women who smoke tend to have low-birthweight babies."

For a smoker taking oral contraception, the risk of cardiovascular disease and stroke could increase by ten times, Professor Olver adds. There are also short-term respiratory symptoms such as decreased lung function, shortness of breath, cough and rapid tiring during physical activity.

When Rose exercises, for example. "I can tell that I can't breathe well because I smoke."

Smoking diminishes the ability to smell and taste. It also causes premature skin ageing and other dermatological problems.

Research published last year in the British Journal of Dermatology found female smokers aged 25 to 40 are four times more likely to suffer from acne — a condition dubbed "smoker's acne face".

But today's young smokers aren't ignorant or naive about the effects of nicotine. Elissa Gannon, a technical support worker for an accounting firm, has smoked about 15 cigarettes a day since she was 20. When she goes out drinking, Gannon, now 28, smokes twice as many.

"The thought that it's bad for me is in the back of my head, but I leave it there," she says. "I feel like I should want to give up, but I don't. I am still healthy and it doesn't affect my life."

Sidestepping the issue

Even when Gannon does notice an effect on her health, she manages to sidestep the issue. "I can swim and walk, but jogging or any high-cardio exercise is a challenge. But I have never liked jogging anyway," she says.

Gannon smoked her first cigarette at school to try to fit in. "I was about 15 and trying to be cool," she says. "As I get older the whole health-risk thing will probably seem worse. I haven't noticed any wrinkles, so that doesn't concern me. I think the one thing that would make me want to give up would be if I got unfit and couldn't keep active and maintain my lifestyle."

Weighty issue

For many other young women, maintaining their fitness is less important than maintaining their weight. When people smoke, nicotine in the cigarette releases a brain chemical called serotonin, which is an appetite suppressant. After quitting, they may want to eat more, and can also crave certain foods.

Additionally, after about two days their sense of taste improves — so food is all the more appealing.

It's not surprising, then, that many who try to quit end up overeating.

"Weight loss is one of the effects of nicotine, and people are concerned about putting on weight when they give up," says Professor Olver.

Yet, according to quit-smoking associations, not every person gains weight when they stop smoking. Among those who do, the average gain is one to four kilograms. Often, this simply puts them into the same weight range as non-smokers their age.

Family legacy

Such details are cold comfort for call-centre worker Maegan Hogarth-Howden. The 19-year-old gave up her packet-a-day habit for three months last year, but started again after she gained five kilograms.

"When I quit I found that I was used to doing things with my mouth and hands. So, instead of smoking, I started eating and drinking. I felt fat and gross."

The fact that almost all of Hogarth-Howden's adult relatives are smokers put her at a distinct disadvantage. Secondary students whose parents smoke are twice as likely to take up the habit as students whose parents don't smoke, according to health authorities.

"My mom and dad and aunties and uncles all smoke," Hogarth-Howden says, "but no-one in my family has had a serious illness from it."

Her relatives keep telling her to give up now before she is addicted. "But I've been smoking for four years now, so I am already addicted," she says.

Since first being interviewed for this article, Hogarth-Howden has started going to the gym and is "getting fitter every week". However, she has only managed to cut down her smoking "a tiny bit".

Neither Nicole Rose nor Elissa Gannon have plans to quit!

This article is from Reader's Digest