Most of my teenage patients have one hand attached to their cell phones during their medical visits. Sometimes they're answering their parents' texts about what time they will be done, and sometimes they're texting their partners to tell them they have chlamydia.

Given that texting has entered exam rooms in my office, I was not surprised to read the results from the 2011 Pew Internet & American Life Project. Pew surveyed 799 U.S. teens 12 to 17 years of age and their parents; they carried out focus groups with 57 teens. Here is what they found:

  • 75 percent text and 63 percent say they text every day.

  • Texting is trending up: the median number of texts rose from 50 per day in 2009 to 60 per day in 2011.

  • Older girls text the most, with a median of 100 texts a day—more than 3,000 texts a month!—compared with 50 texts per day for boys their age.

And then there are hyper-texters. One in 5 teens are "hyper-texters," texting more than 120 times a day.  Hyper-texters are more likely to have sex, engage in binge drinking, use illegal drugs or be in a physical fight than teens who text less.

Who would have thought that our teens could do so many things at once?  They are texting at restaurants, texting on the street, and texting underneath their desks at school.

They're texting in bed … not zzz's. Research also suggests that teens are "sleep-texting": interrupting their sleep to text, some of them even texting in their sleep. They may place their phones on vibrate and sleep with them tucked under their thighs so they will wake up every time they receive a message.

They're texting and driving. One of every 3 students texted or emailed while driving a car at least once during the prior month, according to a study of youth risk behaviors by the Centers for Disease Control. Coupled with teens' relatively limited experience on the road, this is a dangerous combination.

When texting becomes "sexting" ...  Sexting is sending a text message with sexually explicit content or a sexually explicit picture, including naked pictures or pictures of people engaging in sexual acts. One click and what was meant for one person can instantly reach an entire contact list.  An article in Pediatrics reported that 15 percent of adolescents said they had engaged in sexting, and more than half said they knew someone who did. Most importantly, sexting is associated with risky behaviors including having unprotected sex.

Don't get me wrong, I like texting when it's not out of control. In addition to the obvious emergency situations where texting is invaluable, some people have used texting creatively to help others. For instance, is a non-profit organization that connects teens with volunteer opportunities—and is now texting with more than 1 million teens. DoSomething has started an unusual text program that addresses teen pregnancy. First, it virtually impregnates a teen's cell phone. Then, when this cyber baby is delivered, say, on May 20 at 6:31 A.M., the program sends virtual baby texts frequently with the goal of deglamorizing teen pregnancy.

A/N: texting opens up another type of communication between teens and their parents. The use of acronyms often captures what's going on RN in RL surprisingly accurately. Also, IMO, teens have a GSOH, making me LOL, which is often expressed in texting.

Advice to help keep texting safe:

  • Talk about texting and sexting with your teens.  We used to tell our kids "think before you speak." Now the message has to be "think before you send."

  • Check their cell phones to make sure they're texting safely.

  • Set limits. It is estimated that only 3 in 10 teens have family rules about electronic media use!

  • Enforce tech-free bedrooms: free of cell phones, computers, and other electronic devices.

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