If you are one of the millions of households in the United States with Alexa or Google Home, you may have noticed an unfortunate side effect of using the device: a lack of enforced courtesy. Kids (and adults) shout commands at the device: "Play Beyoncé!" or "What's the weather?!" The devices do not require a "please" or "thank you," and the more lifelike these devices become, the weirder it is to hear your child rudely demanding something from a humanlike voice.

Phones vs. Respect for Elders

Internet vs. Value of Boredom

When a phone full of cute cat videos and funny memes is only a swipe away, it's easy to forget what it was like to be truly bored. But science tells us that boredom is actually useful -- for kids and adults. Not only can boredom lead to deep thinking, it can help kids practice perseverance, or pushing through uncomfortable moments without stimulation or distraction. And without boredom, kids might not take the time to explore their surroundings -- dig in the dirt, wonder how a house is built, bake cookies without a recipe -- and they might not stumble on something they really love to do.

Activity Trackers vs. Activity for Its Own Sake

What to do: First, don't buy your kid an activity tracker unless they need it for a specific reason. Second, engage in lots of outdoor activity and fun exercise, and comment on how good it feels. And last, model the behavior and values you want to see in your kid -- even if you're tracking your steps, wait until the walk is over to check your progress, for example.

Devices vs. Empathy

The mere presence of a phone on the table between two people having a discussion has been shown to decrease feelings of empathy. Whether this is because the phone owner is distracted by the possibility of an incoming message or the promise of something more interesting on the device is unclear. But it makes sense that if someone isn't giving you their full attention, they're less likely to understand or empathize with you, and ultimately that can affect the quality of the relationship.

His mother, Diana, thinks back to that period and recoils at the memory. Her son would get angry, she remembers, and throw tantrums if she withheld cigarettes from him or failed to give him money to obtain them. "He (would) start to smash his head to the wall. He was crazy, hurting himself if he didn't get a cigarette," she said.

People would accuse her of being a bad mother and regularly question her parenting skills, she said. "I am a weak mom. He always threaten me if I didn't give him money. ... I (was) afraid he (was) going to die."

Aldi is the youngest of three boys born to Diana and her husband, who requested not to be named. But he is far from the only child who picked up the habit across the islands of Indonesia: More than 267,000 children there are estimated to use tobacco products every day.

A childhood habit

Diana believes Aldi's addiction began with peer pressure and exposure to smokers. He accompanied her each morning to the market where she sells vegetables grown on their land. People there could have taught him to smoke, and he could easily get cigarettes by asking at the market, she said.

In many regions of the world, this might seem unrealistic and like an excuse, but in Indonesia, it's highly likely. The country has the highest percentage of male smokers globally and among the highest rate of adolescent and child smokers in the world -- fueled by lack of control over advertising, relaxed sales and low prices.

Today, Aldi is a healthy young boy who attends school and gets good grades, but to get here, it took years of rehabilitation with the country's leading child psychologist, Dr. Seto Mulyadi, chairman of the nation's National Commission for Child Protection. His road also didn't end with his tobacco cravings. Soon after his recovery, he replaced tobacco with food and began to overeat as a means of compensation, eventually becoming obese.

But a second bout of rehabilitation to tackle this overeating created the healthy, stable young boy sitting beside his mother today.

Mulyadi believes the one benefit of working with children who have an addiction is their mental agility. In Aldi's case, his age and intelligence meant he responded quickly to his treatment, in which Mulyadi distracted the 8-year-old with running, climbing and playing while slowly reducing the number of cigarettes he smoked each day. But treatment was intense and required Aldi to go to Jakarta for a few months to be with Mulyadi every day.

"He was just 3 years old, and he smoked four packs a day," Mulyadi said. "(But) I was confident because he is still very young. Psychologically, as a child, he is very flexible and easier to be cured."

And cured he is -- at least for now.

"I don't want to smoke anymore. I don't want to get sick," said Aldi, who now wants to help prevent other children going through a similar ordeal. "Please don't smoke. Don't even try it. It's hard to quit."

With smoking so commonplace and numbers remaining steady or even rising among some groups in recent years, Aldi's message could go unheard, believes Dr. Lily Sulistyowati, director of prevention and control of noncommunicable diseases at Indonesia's Ministry of Health.

"I'm very worried about smoking in Indonesia," she said, especially among teens ages 15 to 19.

No sign of decline

While rates in most countries fell between 2013 and 2016, the rate of smokers under 18 in Indonesia rose from 7.2% to 8.8%.

But more worryingly, among 10- to 14-year-olds, more than 3% were smokers in both 2013 and 2016 -- the majority of them boys -- and more than 18% of boys and more than 9% of girls 10 to 14 had tried a cigarette, according to Indonesia Basic Health Research data reported in 2013.

The research also found that 1.5% of boys and 1.4% of girls 5 to 9 years old had tried a cigarette.

Sulistyowati believes the problem is worse in rural areas and among poorer populations. "Poor people are spending their money on cigarettes," she said.

In 2013, the richest fifth of the population used 7.1% of their monthly expenditures on tobacco and betel leaf to wrap tobacco, while the poorest fifth spent 12.5%, according to Indonesia's Central Bureau of Statistics. The poorest fifth spent similar proportions of their wages on grains and tobacco -- 15.5% and 12.5%, respectively -- and spent six times more on tobacco than on dairy and egg products.

Rural regions also tend to be populated with people with lower incomes. There, parents' priorities are working and earning money for their families, which can leave children vulnerable to influences such as smoking while parents are distracted. "(These areas) are a different situation. Parents focus on how to work and get money, not on the health of their children," Sulistyowati said.

In addition, children begin working young to earn money that they can then spend on cigarettes, said Dr. Aman Pulungan, president of the Indonesian Pediatric Society, who has been monitoring and working on the issue of childhood smoking for decades. "It's country life," he said.

Smoking among children and teens is still a problem in the cities, highlights Silistyowati, but there, people know that the habit is bad for their health and children instead hide their addiction from their parents, she said. "They try it with friends," she said.

This was the case for Icha, 16, in the capital, Jakarta, who began smoking when she was 13 after a friend offered a cigarette to smoke together. "The first time, I felt dizzy and coughed a lot," she said. "But later on I (felt) the taste is good."

Icha now smokes at least one pack of 12 cigarettes each day and says half of her classmates also smoke, some in front of their parents. Her own parents tried to ban her from smoking but after little success now just ask that she try to reduce her habit.

"There is no parental control," Pulungan said."They just do it, because no one says no."

Pulungan added that many parents don't fully understand the risks associated with smoking and that its prevalence among adults helps that ignorance persist, particularly in rural areas.

Part of the problem, Sulistyowati and other experts say, is the ease of access and pervasiveness of smoking in Indonesian culture.

Marketing and image invasion

"The problem is big," Pulungan said, adding that smoking has been an issue in Indonesia for more than 40 years. "But it's getting worse."

He believes that in addition to peer influence, the root causes of the epidemic include advertising, lack of laws -- or enforcement -- in public spaces, sponsorship of venues by big tobacco companies and the way cigarettes are sold.

Nonsmoking sections in restaurants are very small, he said. In addition, tobacco companies are still sponsoring sporting and musical events as well as public buildings or clubs. This sponsorship has come down in recent years, he said, but he now believes that hidden advertising is growing -- through TV and culture. "(Kids) think if you want to become a man, you have to smoke," he said.

The issues of advertising and masculinity linked to smoking faced many other countries just a decade or two ago, but while rates across the West declined, companies and efforts to boost tobacco interest transferred to countries where bans and laws did not prohibit their existence, such as Indonesia, Pulungan believes.

In rural areas, "the small shops, grocery shops, are sponsored by cigarette companies, and they can put adverts anywhere," he said. "No one controls this." He also mentions sports clubs that have tobacco companies as part of their names.

"Advertising is of more interest to the youth," Sulistyowati said, adding that companies entice adolescents by associating cigarettes with success and fame. "Schools can get sponsorship" from big companies, she said.

Again, while many countries have had bans against this for some time, Indonesia has no national laws in place -- though some municipalities have introduced them, she said, including Western Sumatra.

Of the big six global tobacco companies, Phillip Morris International dominates the market in Indonesia, according to 2013 data from the Tobacco Atlas. The company did not respond to a request for comment.

The Ministry of Health is now working with the Ministries of Education and Communication to help prohibit sponsorship and advertising, as well as the Ministry of Transport to implement and enforce existing smoking bans on public transport.

Almost half of the country's municipalities have regulations in place for smoke-free areas, said Sulistyowati, and universities have committed to having smoke-free campuses through the Ministry of Education. Graphic health warnings were also introduced on cigarette packets in 2014 to put people off the habit.

But "it all depends on the commitment of the local head, or mayor, of a district," Sulistyowati said. "Indonesia is a big country," at more than 1.9 million square kilometers (more than 740,000 square miles).

Easy access and affordability

The final hurdle is the cost and ease with which people can buy cigarettes: They can be bought individually -- which makes them more affordable to people with lower incomes -- and a pack of 12 can cost as little as $1 at most vendors and kiosks, said Sulitsyowati.

All 34 provinces have had regulations in place since 2012 to prohibit the sale of individual cigarettes, but enforcement has not been that effective.

"They buy one cigarette, not a pack usually ... and everywhere you go, you can buy one cigarette, so it's easy," Pulungan said. "Shops easily sell them."

One kiosk vendor in Jakarta, who did not provide his name, said most children buy individual cigarettes from him even though selling them in this form is breaking the law. "Everyone sells cigarettes to them," he said.

Globally, experts agree that one of the strongest tobacco-control policies has been taxation. The rising cost of the habit, linked to higher taxes, has meant that many can no longer afford to smoke, and those who can smoke provide revenue for anti-smoking campaigns and quitting support services, to name a few options.

"In states where we see the highest tax rates, we see the lowest prevalence," he said, highlighting New York City, where former Mayor Michael Bloomberg introduced city taxes on top of state taxes in 2010.

In Indonesia, "the price of cigarettes is very cheap," Sulistyowati said. "Everyone can buy them."

Pushing for change

With all this eventually in place, Aldi's message may finally reach those who need to hear it: young children facing the allure of smoking tobacco.

Though cases like Aldi's seem very rare on the surface, there are similar ones in Indonesia that don't get serious attention, said Mulyadi, who treated Aldi.

"Aldi was very lucky because in his case, we get a fast response from the government and public. ... Local and international media give him big attention," he said. "Other children are not that lucky."

The Indonesian government is not strict enough, he said. "As long as cigarette ads are spread out massively on TV, radio, newspapers, outdoor signage, everywhere, the problem of child smokers will get worse and worse."

Rather, a public health problem can arise when non-certified professionals market invasive procedures on the social media app and prospective patients may not ensure that the person behind the marketing is board-certified for that surgery, he said.

"We've all heard these headlines in recent years of some terrible things that have happened in association with surgery that was not being done in the safest possible manner," Schierle said.

'Social media takes it to yet another level'

The new study involved more than 1 million Instagram posts that were uploaded January 9. Each included at least one of 21 plastic surgery-related hashtags such as #plasticsurgery, #plasticsurgeon, #breastlift or #nosejob.

Among the hashtags in the study, "the use of colloquial or layperson terminology for cosmetic surgical procedures seems to be much more popular than the use of technical terminology," Schierle said, such as #tummytuck over #abdominoplasty.

The researchers analyzed the Instagram posts to find the top nine associated with each of the 21 hashtags, and they recorded data on who did the posting, referring to the Instagram profile associated with each post.

"The Instagram app itself automatically categorizes the top nine posts. Whenever you do a given search, the first nine results that show up are identified as top posts," Schierle said. "The top nine are based on how many followers the person has and how many likes the particular post has."

The researchers wrote that the online presence of surgeons who are not board-certified in plastic and reconstructive surgery in the US and Canada often comes at the expense of patient safety and dangerous outcomes.

Globally, the majority of the top posts for each hashtag came from surgeons outside the United States, including Turkey, Russia, Brazil, Colombia, the Dominican Republic and the United Arab Emirates, the researchers found. However, those posts were not analyzed to determine the poster's board certification status.

Plastic surgeons have long warned against traveling internationally for unsafe plastic surgeries, and Schierle said he has corrected some botched procedures from overseas among his own patients. Now, however, consumers should be warned of unsafe procedures being promoted on social media, he said.

"Social media takes it to yet another level in terms of the impact that people can have and how rapidly they're able to kind of establish themselves as something that they may or may not actually be," Schierle said.

Still, the new study comes with limitations, including that it involved only one day's worth of Instagram data -- all the posts were from January 9 -- and that the data were pulled from a single social media platform.

The researchers plan to conduct followup studies over a longer time period and across an array of social media platforms, including Snapchat, Schierle said.

"More data need to be collected in terms of seasonality, how cyclical the data are, as well as the overall trend," he said. All in all, the study reveals that the underrepresentation of board-certified plastic surgeons among the top posts on Instagram should be something for potential patients to be aware of, he said.

Tips for finding a plastic surgeon, and questions to ask

"Instagram has become a convenient way for patients to see a surgeon's work and get a sense of the types of procedures being performed," Jones said.

"It is quickly becoming a go-to source for millennials," he added. "In today's society, patients want to get to know the surgeon before ever stepping foot into the office."

For consumers, it's not always easy to determine whether a plastic surgeon on Instagram is board-certified, said Schulman, who was not involved in the study. He added that he routinely lectures plastic surgeons at national and regional meetings about the usefulness and advantages of social media.

"Some physicians have specific information in his or her bio. However, many non-board-certified plastic surgeons are not forthcoming about specific training," Schulman said.

"Some may be outright deceitful, but most deceive by omission. Being a board-certified plastic surgeon takes many years of training, examinations, certifications, and is something to be proud of," he said. "I can assure you that if a physician is a board-certified plastic surgeon, this will be prominently featured on his or her bio."

You might not be able to control everything your child eats, especially when your kids are not at home, but you can give them a good healthy foundation. She suggests not bringing junk food into the house: "If it's not there, they won't eat it." Don't plead or threaten or bribe your child to eat healthy food, she says, because those tactics are not effective. And don't judge your child's tastes by your own. "You may not like broccoli, but your child is not you. He/she may love foods that you don't care for," Achindu said.

2. Make food interesting

Same with mussels marinara, which became one of her daughter's favorite foods. She enjoyed inspecting the mussels and looking for the potentially dead ones to throw away, learning about their biology and pulling the cooked shells all the way apart and picking out the meat.

"My main tip is to make food interesting if your child is naturally curious, enjoys science/nature and is willing to engage," Day said.

3. Get the kids involved

"They delight in going out back, getting dirty and picking the veggies. I watch them eat them raw," she said. "They seem to delight in what they've grown, and there's never a battle."

4. Give kids choices

"Give them more room to choose as they get older," she added. And never get into a power struggle with your kids about eating, food or even healthy food, she said. "Make sure you are not overcontrolling, overeducating or over-lecturing them, or they will rebel in the food arena."

5. Get creative

He noticed the change in color but continued to enjoy the taste, so as time went on, she added more and more greens. Now, he can drink a kale or spinach drink with no issue. "The juices helped him develop taste for veggies. He also notices how much better he feels when he drinks them consistently," she said.

McSweeney, the podcast host, has another idea, this one for younger kids: Present healthy food in a creative way, such as hosting a purple night. "Everyone dresses in purple for a purple meal. Menu items could include purple peppers, purple cauliflower, purple potatoes, grapes and/or eggplant," she said. "Savor the day!"

6. Model healthy eating

Added Parnass, the author and psychotherapist, "Our children will ask for bites as time goes on, as they like to copy what we do, not what we say."

7. Forget about making your kids clear their plates

Moore, of the Whatevs blog, said she and her husband never force their kids to eat anything and are not in a habit of fixing them a separate dinner. "If they refuse to eat the meal, we tell them that's OK, but that's all there is, and they can eat again at breakfast," she said. "If they want a second helping of, say, steak, and they have not finished whatever veggies are on their plate, we tell them they have to finish what's there before they can have more of something else."

8. Words matter

John Furjanic, a single father of one, said his daughter is the second-smallest child in her elementary school class -- she's about to begin fifth grade -- and is acutely aware of the size difference between her and her classmates. Recently, she surprised Furjanic by repeating one of his mantras, which is "Protein builds muscles."

"I flex my muscles when I say it, and she rolls her eyes, but apparently she has been listening," said Furjanic, who works as a financial adviser. "I'm ecstatic that she is asking me to make chicken, steak and eggs."

9. Get colorful

10. Consider "litterless lunches"

11. Experiment

Jennifer Bosse, a mother of two boys ages 4 and 6, analyzed the family diet a few years ago and realized there were some "obvious tweaks" they could make to ensure healthier eating. She realized they were consuming a lot of bread at each meal, and pasta was on the weekly lunch and dinner rotation. So, she did some research and started trying new things.

Instead of pasta noodles for spaghetti, she switched to spaghetti squash. When she makes baked goods like muffins, she uses alternative flours like coconut and almond. Instead of oil, she uses unsweetened applesauce.

Between the two extremes is a wide range of satisfactory flexibility levels. Being on the upper end of the range may impress your friends in yoga classes or games of Twister, but it won't necessarily confer any additional health benefits.

Instead of worrying about how your flexibility stacks up against that of others, you should focus on what's right -- and realistic -- for yourself. Assess what your needs are and how stretching might address them. For example, maybe a certain part of your body is especially inflexible and holding you back in your workouts. Or perhaps you want to improve your flexibility to help your tennis or golf game, or to get on the floor and play with your kids or grandkids.

Whatever the case, here are a few relatively simple tests you can use to assess your flexibility. Do them after a warmup or workout.

Sit and reach

Developed in the 1950s, this classic test of flexibility in the hamstrings and lower back has several variations. Here's a DIY version from the YMCA that requires only a yardstick and masking tape.

Zipper

This test of shoulder flexibility measures how closely you can bring your hands together behind your back. You need a tape measure or ruler and an assistant.

Sitting-rising

This test, developed by a Brazilian doctor, has received attention as a tool to predict mortality risk in middle-aged and older people. But research suggests that it can also be an indicator of flexibility (as well as strength and balance) in people of all ages. No equipment is required, but you need sufficient space and a surface that's not slippery.

There's no need to get perfect scores on these tests -- though if you do, that's great. Instead, use the results to track improvements in flexibility over time. That way, you can tell whether all those shoulder stretches or Cobra poses are paying off.