States' Anti-Smoking Campaigns Paying Off

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While a recent national survey found that more than one-third of high school students and almost 13 percent of middle school students reported having recently smoked or chewed some form of tobacco, a handful of states have created programs that are helping them to buck the national trend.

The American Legacy Foundation, in collaboration with the Centers for Disease Control Foundation, conducted the 1999 National Youth Tobacco Survey, the first to look at children ages 11 to 13. The federal Centers for Disease Control and Prevention provided the nonprofit foundations with scientific and technical assistance.

More information is available at and
SOURCE: National Youth Tobacco Survey

The study estimates that one in eight, or 12.8 percent, of middle school students in grades 6-8 had used tobacco—cigarettes, smokeless products, cigars, pipes, bidis, or kreteks—in the past month. Among high school students, the overall prevalence of tobacco use was 34.8 percent.

Massachusetts Results

Despite such troubling findings, six states—Arizona, California, Florida, Massachusetts, Mississippi, and Oregon—have created comprehensive programs that have had considerable success in reducing tobacco use, according to the Washington-based Campaign for Tobacco-Free Kids.

Those campaigns include anti-tobacco advertising; community-based projects that bring in local businesses and organizations to provide counseling, training, or youth education; and cessation services that help smokers quit. Many also rely on school health classes, rigorous enforcement of laws prohibiting tobacco sales to youths, and research and evaluation.

Anti-smoking activists point to Massachusetts as a prime example of what can happen if appropriate measures are taken. The state created the Massachusetts Tobacco Control Program in 1993. Last year alone it spent nearly $36 million, most of which went to media campaigns, a hot line, a school health program, and research and evaluation. As a result, high school smoking rates have resisted the national trend, declining slightly from 1995 to 1997, while national rates continue to rise.

"The vast majority of states have done little or nothing to reduce smoking in their states," said Joel Spivak, a spokesman for the Campaign for Tobacco-Free Kids, a nonprofit group. The thinking in many states, Mr. Spivak said, is that youth smoking is not a serious problem.

Even those that do recognize its seriousness, he said, may not keep up with all the studies showing the types of programs that work well.

More states, though, seem willing to try. Eight states—Hawaii, Maryland, Massachusetts, Minnesota, New Jersey, Vermont, Wisconsin and Washington—made substantial, new commitments last year to subsidize tobacco-prevention and -cessation programs, using funds from the 1998 tobacco settlement, according to a report from the Campaign for Tobacco-Free Kids.

New Products Flourish

The survey, conducted last September and October, questioned more than 15,000 students in grades 6-12. Cigarettes remained the most widely used product, but novel ones known as bidis and kreteks—inexpensive cigarettes with such flavors as chocolate, cherry, and clove—are emerging as a public health problem, according to the researchers.

Also of concern are rising rates of smoking by black youths. Previous surveys have shown that even though cigarette smoking among African-American high school students has been climbing, their rates were still much lower than those of their white and Hispanic peers.

Moreover, the CDC's latest findings indicate that cigarette-smoking rates among African-American middle school students are similar to the rates of other middle school students.

The similarities in middle school students may merely be a function of age. A person is more likely to start smoking or experimenting with tobacco at the middle school level, said Steven Kelder, an associate professor of epidemiology at the school of public health at the University of Texas Health Science Center in Houston. By the time young people reach high school, many have already experimented and decided not to smoke, he said.

Mr. Kelder conducted a series of focus groups for the CDC with 6th and 12th graders from the Houston district in 1996 and 1997 to determine why white youths smoked more than African-Americans.

Though the results of the focus groups weren't definitive, Mr. Kelder said, one difference was evident: "African-American parents were more vigilant than white parents when it came to [their children's] smoking," he said.

Vol. 19, Issue 22, Page 12

Published in Print: February 9, 2000, as States' Anti-Smoking Campaigns Paying Off
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