I remember the day I rode around the resort in a golf cart with my grandfather and we just talked. That was the last time I was with him. I watched him struggle with the effects of emphysema for about two years before he passed away last year when I was just 13.

His death made me think a lot about how families influence habits like smoking. And it made me worry about my parents, grandma and other relatives, who all smoke.

Emphysema is associated with long-term exposure to tobacco smoke and toxic chemicals. Eventually it makes it impossible to breathe. I know that's not what my grandfather expected when he started smoking as a teen. When he was growing up, his parents smoked around him.

When parents smoke around their children, the kids are more likely to smoke too, said Dr. Marc Manley, vice president and medical director of population health at Blue Cross and Blue Shield of Minnesota.

Many reasons, many diseases
Teens start smoking for many different reasons: peer pressure, they think it's cool and because their parents and guardians smoke around them. I tried it once. But since my grandpa died, I'm not interested.

When people start smoking at a young age, they are more likely to get certain diseases and illnesses as they grow up, Manley said. The most likely are cancer, heart disease, and chronic lung disease. Even when smokers' children and teens do not smoke they are exposed to second-hand smoke, which can cause lower respiratory infections, asthma, and clogged ear tubes, he said — those tubes run from each ear to the throat and inhaling smoke irritates and blocks that tube so the liquid can't drain and gets infected.

Like a lot of people, my mom thought she could stop smoking whenever she wanted. But nicotine affects the pleasure centers in the brain and over time people find that they really need a cigarette and if they don't have one they feel bad or different, Dr. Manley said. When that happens, you know that you are addicted.

My mother quit for about 20 years but would have just one cigarette when she went to visit a friend. Unfortunately, after a few times she was addicted again.

When I interviewed the smokers in my family, I could see how they started smoking and why it's so hard to stop.

A household of smoke
Rebecca Sufka, my uncle's fiancée, started smoking when she was 16. Her parents both smoked around her and never told her not to smoke. She also thinks that watching other peers and friends smoked influenced her take up the habit. Sufka has smoked for 20 years and she smokes a pack a day. She thinks that she will only quit if she has a child.

My uncle Scott starting smoking when he was 18 because he thought he was a "bad ass." But he believes that if his parents hadn't smoked around him while he was growing up he never would have started smoking. My uncle said he doesn't think he could quit smoking; he knows that he is addicted — routinely smoking a pack a day and more when he is stressed.

My grandma, Shirley Purkapile, started smoking when she was 22. Both of her parents smoked around her and they told her never to pick up the habit. One day she was angry so she lit up a cigarette. That one cigarette started her 40-year, pack-a-day addiction. She also told her children never to smoke but smoked around them.

My father, Clarence Purkapile, started smoking when he was 18. When he first started, he thought that he could quit anytime. He's now been smoking for 24 years.

When you become addicted, it's like "cigarettes come first, at least that's what it seems like," Sufka said.

I think smoking is basically suicide. Growing up around parents who smoke is definitely a challenge. When I was young, I didn't understand the concept of second-hand smoke very well. Now that I know that smoking kills, I try to express my feelings as much as I can toward my family.

When teens start smoking they don't realize how hard it is to quit. When parents smoke around teens they don't understand the influence they have on their kids.

Elise Purkapile is a student at St. Anthony Village High School and a participant in ThreeSixty, a youth journalism program based at the University of St. Thomas in St. Paul.