The JAMA Pediatrics study used data from more than 100,000 teenagers to assess sexting habits.

We're going to talk about teenagers and the electronic transmission of a sexually explicit photo or video – sexting as they call it – today. Before we begin, I want to take pains to avoid the moralistic impulse to condemn such behavior. A cursory look at historical writing will find that the transmission of taboo, saucy, or provacative material is as old as the written word.

In 1800, British naval hero Horatio Nelson wrote his mistress Emma Hamilton a tale of an erotic dream: "I kissed you fervently and we enjoy'd the height of love".

Not steamy enough for you? Google "James Joyce love letter". Not in front of the kids. Is sexting the modern equivalent of these erotic epistles? And just how common is it?

Pretty darn common, but that is not the most important statistic in this study which appeared in JAMA Pediatrics.

Researchers from the University of Calgary combined the results of 39 Teen sexting studies to create one uber-study, also know as a meta-analysis, which included data from 110,380 US teens.

One in seven teens reported sending a sext, and one in four reported receiving one, with roughly equal numbers between boys and girls.

The rate of sexting has climbed steadily over time, about 2.6% per year between 2009 and 2016 as smartphones have become ubiquitous.

Now, because these kids are underage, there are some important legal risks to possessing or transmitting these images, but criminal prosecution is not the main risk here.

In fact, some researchers have argued that sexting is a normal part of sexual development in teenagers.

This longitudinal study in the journal Pediatrics found that kids who sent sexts were more likely to have sex subsequently, but the rate of risky sexual behavior was no different than the kids who weren’t sexting at all. As part of a healthy adolescent relationship, is sexting just – no big deal?

One statistic from the JAMA paper really worried me. About 10% of kids reported that they had a sext that was forwarded to someone else against their will. That's only slightly less than the number of kids who were sending sexts at all. Put another way, if you are a teen engaged in sexting, the odds are very high that your pictures are going to be shared. Gender did not modify this – boys and girls were equally at risk.

This is crazy. These pictures leaking out into the wider world can have devastating, even fatal consequences.

Now, preventing teenagers from doing… anything… might be pretty difficult. But as with sex education, sext education may be a good idea. Teens need to know that they are exposing themselves (sorry) to legal risk, but also that anything they send will likely be seen by someone they are not sending it to. That’s the world they are living in. So, if the youthful ardor is stirring, advise your teens and teenage patients to do what Horatio Nelson would have done – write a steamy letter.