‘Tobacco-Free’ Haze

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In a dozen years of working with kids, I saw the same scenes a hundred times: parents, family friends, relatives and teenagers smoking around the kitchen table; children, red-faced in the blue haze, soon to sample the grown-up ritual. Yet anti-smoking luminaries led by the National Campaign for Tobacco-Free Kids (TFK) remain silent while children marinate in adults' smoke, then brand teenagers as rebellious dupes of tobacco advertisers for trying the adult habit.

TFK blames America's tobacco scourge on the "horrible truth" that "3,000 children begin smoking every day." Yet TFK soft-pedals the worse truth: every day 25 million children are exposed to so much adult cigarette smoke that their blood retains measurable nicotine levels. Whether "pre-addicted" physically or by adult example, smokers' children are several times more likely to smoke than are nonsmokers' children.

Teen and adult smoking rates are so strongly correlated (both are highest in Kentucky, lowest in Utah) that they represent the same behavior. Recognizing these connections, U.S. Surgeon General C. Everett Koop declared in the 1980s that achieving a "tobacco-free society" required changing social norms.

But America's once vibrant anti-smoking movement dodges tough issues, pushes poll-tested crowd-pleasers, and functions largely for politicians and institutional aggrandizement. According to TFK, there's one reason youths smoke (industry marketing) and one reason they don't (programs rescue them). Such one-dimensional melodrama is inadequate to address complex motivations. Splashy "stings" against stores to curtail "youth access" to tobacco are futile, even counterproductive. (See the New England Journal of Medicine, Oct. 9, 1997).

Anti-smoking groups' obsession with youth, access and ads exemplifies today's politically deformed priorities. From 1970 to the early 1990s, when tobacco ad spending rose rapidly and youths could buy cigarettes more freely than today, teen smoking plummeted. After 1992, when tobacco ad spending declined and crusaders attacked youth smoking, teen smoking rose sharply.

While TFK argues that more young smokers chose Camels when Joe Camel ads proliferated from 1998 to 1993, it fails to note that smoking among 12-to-17-year-olds declined 20 percent during that period. Although the unscrupulous industry would love to lure kids, only a few dubious studies claim that ads are major enticers. The most-cited study, by Dr. John Pierce, employs criteria so vague that it reports 75 percent of all teens are progressing toward smoking and that parents and peers have no influence - claims amply contradicted by dozens of studies and strong teen-adult smoking correlations.

TFK exaggerates teen smoking, helping the industry legitimize cigarettes as normal. After 160,000 teenagers overwhelmingly endorsed tough smoking controls, TFK sniffed, "Kids are tired of being manipulated by Big Tobacco." What condescending claptrap; if kids were industry puppets, they wouldn't overwhelmingly reject smoking and support anti-industry controls.

Big tobacco's manipulation of TFK is a bigger concern. TFK's obsession with scoring pointless youth-smoking points helped the industry win disastrous concessions in the recent Master Settlement of state lawsuits. Now TFK asserts (from sparse evidence) that a few prevention programs (i.e., Florida's) cut teen smoking. Such simplistic credit-claiming (as untenable as saying Joe Camel's 1988 debut caused the subsequent four-year teen smoking drop) thwarts rigorous analysis needed to design effective plans.

Fortunately, some state and local tobacco control advocates are exploring complex strategies incorporating the realties that smoking is not normative to teenagers, that today's teen smokers smoke more lightly than past ones did, and that youth smoking is conforming, not rebelling, behavior as long as society accepts "adult" smoking. Enough of the failed 1990s preoccupation with camels, tobacco access and anti-youth negativism. Let's put the money on new ideas.

Mike Males' latest book is Smoked: Why Joe Camel Is Still Smiling.