Surgeon General's Anti-Tobacco Battle Plan

Report examines youth tobacco use, recommends higher prices, more programs

Regina Benjamin

WASHINGTON-- Continuing the week's anti-tobacco assault, U.S. Surgeon General Regina Benjamin issued "Preventing Tobacco Use Among Youth & Young Adults," a new report that "describes the epidemic of tobacco use among youth ages 12 through 17 and young adults ages 18 through 25." Along with health issues, it "examines the social, environmental advertising and marketing influences that encourage youth and young adults to initiate and sustain tobacco use."

Earlier this week, anti-tobacco groups Campaign for Tobacco-Free Kids and Counter Tobacco, as well as the American Heart Association, release their own highly contentious report, "Deadly Alliance: How Tobacco Companies & Convenience Stores Partner to Market Tobacco Products & Fight Life-Saving Policies," which accused convenience stores of acting as economic and political "front groups" for the tobacco companies.

(See Related Content below for previous CSP Daily News coverage of this report.)

Among the claims of the Surgeon General's report:

  • More than 600,000 middle school students and three million high school students smoke cigarettes.
  • Rates of decline for cigarette smoking have slowed in the last decade and rates of decline for smokeless tobacco use have stalled completely.
  • There could be three million fewer young smokers today if success in reducing youth tobacco use that was made between 1997 and 2003 had been sustained.
  • Rates of smokeless tobacco use are no longer declining, and they appear to be increasing among some groups.
  • Cigars, especially cigarette-sized cigars, are popular with youth. One out of five high school males smokes cigars, and cigar use appears to be increasing among other groups.
  • Use of multiple tobacco products--including cigarettes, cigars and smokeless tobacco--is common among young people.
  • Prevention efforts must focus on young adults ages 18 through 25. Almost no one starts smoking after age 25. Nearly 9 out of 10 smokers started smoking by age 18, and 99% started by age 26. Progression from occasional to daily smoking almost always occurs by age 26.

It also said that "youth are vulnerable to social and environmental influences to use tobacco; messages and images that make tobacco use appealing to them are everywhere."

Pressure from peers, siblings, movies, video games, websites and communities influence young people to smoke, and they often see smoking as the social norm, according to the report.

Like the earlier report, the Surgeon General's report also goes after marketing by tobacco companies. It concludes "that tobacco product advertising and promotions still entice far too many young people to start using tobacco."

Richmond, Va.-based Altria Group Inc. issued the following statement in response to the Surgeon general's report:

"Altria's tobacco companies--Philip Morris USA, U.S. Smokeless Tobacco and John Middleton--market to adults who use tobacco. Altria's tobacco companies market in two ways: through age-verified direct communications to adult tobacco consumers and in retail stores where adult tobacco consumers make their purchase decisions. We do not use TV, newspapers, radio, billboards or product placement to advertise our products. The vast majority of our marketing expenditures come in the form of price promotions. It's important to note that the average price of a pack of cigarettes has increased by 78% from 2000 to 2010.

"We agree with the Surgeon General and others that kids should not use tobacco products, and we share the common goal of keeping tobacco products out of the hands of kids. Tremendous progress has been made in reducing overall underage tobacco use, which is at its lowest level in a generation. In fact, today, underage smoking ranks lower than alcohol or marijuana use. We are encouraged by recent government data that show illegal retail tobacco sales to minors are at historic lows. While significant progress has been made in reducing underage tobacco use over time, we agree that more work needs to be done."

Altria added, "There is more tobacco-generated revenue available to states and the federal government today than ever before to fund proven-effective efforts to prevent underage tobacco use; however, the Centers for Disease Control have said that many states have not devoted adequate funding toward youth smoking prevention and cessation programs, and we think they should."

The report, however, said that "regardless of intent, this marketing encourages underage youth to smoke. The more young people are exposed to cigarette advertising and promotional activities, the more likely they are to smoke."

The report also claimed that extensive use of price-reducing promotions has led to higher rates of tobacco use among young people than would have occurred in the absence of these promotions.

Many tobacco products on the market appeal to youth, it said. Some cigarette-sized cigars contain candy and fruit flavoring, such as strawberry and grape.

Many of the newest smokeless tobacco products do not require users to spit, and others dissolve like mints; these products include snus, dissolvable strips and lozenges. Young people find these products appealing in part because they can be used without detection at school or other places where smoking is banned, the report said; however, these products cause and sustain nicotine addiction, and most youth who use them also smoke cigarettes.

Through the use of advertising and promotional activities, packaging and product design, the tobacco industry encourages the myth that smoking makes you thin, the report also said.

The Surgeon General laid out her goal in the preface: "By strengthening and continuing to build upon effective policies and programs, we can help make our next generation tobacco free."

Strategies that comprise successful comprehensive tobacco control programs include mass-media campaigns, higher tobacco prices, smoke-free laws and policies, evidence-based school programs and sustained community-wide efforts, she concluded.

Click here to view the full report.

[Editor's Note: CSP Daily News does not endorse the opinions, assertions, conclusions or recommendations found in the Surgeon General's report.]