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TO: Public Affairs Staff

Date: 06 Dec 1995
Length: 25 pages

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Abstract

Attached is the current edition of"The CQ Researcher," highlighting teens and tobacco. The publication, issued weekly, claims to take a "even-handed and unbiased approach to complex, controversial issues." TI Spokesperson Tom Lauria presents the industry's point of view; John Pierce, Elizabeth Whelan and others speak for anti-tobacco interests.

Fields

Named Organization
American Cancer Society
American Council on Science and Health (Formed by the petrochemical industry for scientific defense)
American Lung Association
Voluntary health organization concerned with fighting lung disease, promoting lung health and advocating clean air, indoors and out.
American Medical Association (physicians group)
Professional trade group representing American physicians.
American Public Health Association (Public health organization)
Professional organization for people working in public health
American Tobacco Company
Americans for Nonsmokers' Rights (Anti tobacco organization)
Concerned with clean indoor air.
ASH (Action on Smoking and Health)
Action on Smoking and Health
Association of National Advertisers (Ad group)
Group of advertising entities nationwide.
Atlanta Constitution (Newspaper)
Atlanta Journal Constitution
Boston Globe
Brown & Williamson Tobacco Corporation (B&W)
Subsidiary of BAT U.S., located in Louisville, KY.
Campaign for Tobacco-Free Kids
Catholic Church
Centers for Disease Control and Prevention (CDC)
Chapel Hill
Chicago Tribune
Denver Post (newspaper)
*Department of Health and Human Services
Department of Health and Human Services (HHS)
Detroit News/Free Press
Federal Communications Commission (U.S. government agency regulating TV, radio)
Enforced the Fairness Doctrine against the tobacco companies; required time be provided on TV, radio for anti-smoking commercials.
Federal Communications Commission (FCC)
Federal Register (publication)
Federal Trade Commission (Enforcement agency for laws against deceptive advertising)
Enforces laws against false and deceptive advertising, including ads for tobacco products. Ensures proper display of health warnings in ads and on tobacco products;collects and reports to Congress information concerning cigarette and smokeless tobacco advertising, sales expenditures, and the tar, nicotine, and carbon monoxide content of cigarettes.
Federal Trade Commission (FTC)
Food and Drug Administration (FDA)
George Washington University
*Health and Human Services (HHS) (use United States Department of Health and Hum (US)
Interfaith Center on Corporate Responsibility (socially responsible action arm of Protestant, Catholic, & J)
Journal of the National Cancer Institute (scientific periodical)
Knight-Ridder Inc.
Liggett Group Inc. (American cigarette manufacturer)
American cigarette manufacturer, was the first to start selling discount brands (GPC)
Lorillard Tobacco Co. (American cigarette manufacturer)
American cigarette manufacturer; makes Kent, MaxSatin, Newport, Old Gold, Style, and True cigarettes.
Los Angeles Times
Miami Herald (Newspaper)
National Institutes of Health (NIH)
New York Times
Office on Smoking and Health
Responsible for creating reports on the health effects of smoking. Created by the Public Health Service.
Philadelphia Inquirer
Philip Morris & Co. Ltd. (Cigarette manufacturer, incorporated in U.S. in 1902)
Philip Morris & Co. Ltd.., was incorporated in New York in April of 1902; half the shares were held by the parent company in London, and the balance by its U.S. distributor and his American associate. Its overall sales in 1903, its first full year of U.S. operation, were a modest seven million cigarettes. Among the brand offered, besides Philip Morris, were Blues, Cambridge, Derby, and a ladies favorite name for the London street where the home companies factory was located - Marlborough.
Philip Morris Companies Inc. (Parent company of Philip Morris USA, Kraft, Miller)
America's seventh-largest industrial enterprise in 1993, owns Kraft, Miller Brewing, General Foods, and more.
R.J. Reynolds Corporation (second tier subsidiary of RJR Industries)
R.J. Reynolds Tobacco Co. (Cigarette manufacturer (Camel, Winston, Doral))
Cigarette manufacturer (Camel, Winston, Doral)
RJR Nabisco Inc. (Delaware corporation, subsidiary of RJR Nabisco Holdings)
Subsidiary of RJR Nabisco Holdings Corp.
Tobacco Institute (Industry Trade Association)
The purpose of the Institute was to defeat legislation unfavorable to the industry, put a positive spin on the tobacco industry, bolster the industry's credibility with legislators and the public, and help maintain the controversy over "the primary issue" (the health issue).
United Nations
United States Tobacco Company (Producers of Copenhagen/Skoal chewing tobacco)
Producers of chewing tobacco
*University of California (use specific branch)
University of California San Diego
University of California San Francisco
University of Michigan
University of North Carolina
USA Today
Wall Street Journal
Washington Post (Newspaper)
White House
Named Person
Adler, David
Banzhaf, John F., III (Exec. Dir. Action of Smoking & Health (ASH))
Executive Director of Action on Smoking and Health (ASH).Professor of Law at Georgetown. Banzhaf succeeded in using the Fairness Doctrine to get cigarette commercials off television in 1968. See Banzhaf FCC, 405 F, 2d 1082 (D.C. Cir. 1968) (affirming FCC ruling that radio and television stations must devote a significant amount of broadcast time to case against smoking). His telephone number is (202) 659-4310. The big focus in past years has been to force OSHA to enforce smoking bans, per Matt Bars. ASH publishes Smoking and Health Review bulletins. "A leading anti-smoking activist" (Chic. Sun-Times 6/23/93). Action on Smoking and Health is located at 2013 H Street, N.W., Washington, D.C. 20006. (Castano Expert List) See Action on Smoking a Health, TTLA Almanac - Names.
Barnes, Andrew
Bonnie, Richard J.
Bouchard, Renee
Burney, Leroy E., M.D. (U.S. Surgeon General 1957)
Dr. Leroy E. Burney was the United States Surgeon General under Eisenhower (1957) (E. Whelan 1984; Dallas MN 1/12/94).
Camel, Joe
Cart, Julian
Castano, Peter (Cancer Victim in Castano v. ATC)
Plaintiff
Clark, Charles S.
Colin, Thomas J.
Cooper, Mary H.
Crawford, Victor (TI Lobbyist (1986-91), Anti-Tobacco Spokesman (1992))
Victor Crawford is a former tobacco lobbyist. Crawford has throat cancer (1994) and is anti-tobacco (Health Line 8/2/94). Victor Crawford, a successful attorney from Rockville, Maryland, and former lobbyist for the Tobacco Institute had tobacco induced cancer. Crawford decided in November 1992 to go public with his misgivings about his work for the tobacco industry. Crawford was a lobbyist for the Tobacco Institute from 1986 to 1991. He was a member of the Maryland Legislature from 1966 to 1983. He practiced law in Rockville, Maryland. (Victor Crawford article published in the Corporate Crime Reporter 13, Monday, 3/13/95)
Donahue, Daniel W. (RJR General Council)
Defense
Donegan, Craig
Donoho, Pat
Duck, Donald
Elders, M. Joycelyn, M.D. (Former Surgeon General)
Plaintiff
Eriksen, Michael P., Sc.D. (CDC Director of Smoking & Health)
Plaintiff
Evans, Nicola
Fontaine, John
Gilpin, Elizabeth A., Ph.D. (Researched effect of anti-smoking campaigns on smoking behav)
Gingrich, Newt (Speaker of the House after Republicans regained control of H)
Speaker of the House after Republicans regained control of House in 1994
Glantz, Stanton A.
Goodman, Benny
Goodman, Jordan
Hams, Tonya
Hauck, Edward S.
Hilts, Philip J. (Authored the book, "Smokescreen, An Analysis of Tobacco Indu)
Plaintiff
Ill, F. Banzhaf
Jaffe, Daniel L.
Johnson, Lyndon B.
Johnston, Lloyd D.
Jost, Kenneth
Kessler, David A., M.D., J.D. (Former FDA Commissioner)
appointed FDA Commissioner by President George Bush in December 1990.
Klausner, Richard D., M.D. (Director of NCI, cessation researcher)
Kurtz, Howard
Lake, Crystal
Lauria, Thomas (Tobacco Institute spokesman)
Spokesman for the Tobacco Institute in 1994 (U.S. News 4/18/94).
Lauria, Tom
Letterman, David (tv host)
Lynch, Barbara S.
Magner, Sarah M.
Merry, Robert W.
Mills, Sherry L.
Mouse, Mickey
Pierce, John (Lawyer)
Pierce, John P., Ph.D. (Epidemiologist, U of CA, San Diego, Anti-Tobacco Expert)
Ryder, Winona (actress)
Schwartz, John (Reporter)
Skene, Nell
Slater, Christian
Stencel, Sandra
Terry, Luther Leonidas, M.D. (Surgeon General, 61-65, U of Pennsylvania, Anti-Tobacco Expe)
Luther Terry was former Surgeon General of the United States Public Health Service from 1961 to 1965. Terry was emeritus professor of Research Medicine at the University of Pennsylvania School of Medicine in 1984 (E. Whelan 1984).
Travolta, John
Varmus, Harold E. (NIH director, Nobel laureate)
Defense
Wellington, Denver Mayor
Whelan, Elizabeth
Whelan, Elizabeth M.
Date Loaded
16 Mar 2005
Box
9040

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Page 1: TI31241619
TO: Public Affairs Staff Federal Relations Staff FROM: Carol Flrycaj December 6, 1995 Attached is the current edition of"The CQ Researcher," highlighting teens and tobacco. The publication, issued weekly, claims to take a "even-handed and unbiased approach to complex, controversial issues." TI Spokesperson Tom Lauria presents the industry's point of view; John Pierce, Elizabeth Whelan and others speak for anti-tobacco interests. Attachment co: Pat Donoho TI31241619
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Researcher PUBLISHED BY CONGRESSIONAL ~UA~TERLY INC. Te:e:ns and Tobacco Do cigarette ads encourage teens to start smoking? ~tudies show that 80 to 90 percent of U.S. smokers took up the habit before age 20. No wonder, then, that teenage consumers interest both the tobacco industry and anti-smoking activists. Industry officials say cigarette advertising is aimed only at smokers age 18 and older, and that younger smokers start because of peer pressure. For their part, anti-smoking groups say cigarette ads and promotional campaigns deliberately target youngsters under 18, the legal smoking age nationwide. The struggle between the tobacco industry and its foes now centers on proposed federal regulations that would curb youth-oriented tobacco marketing. However, leading tobacco companies and national advertising groups have filed separate suits seeking to undo the rulemaking package before it can be implemented. 1065-1088 Formerly Editorial Research Reports }: ..... Tim ISSUES ........................ 1067 :" "~'~'{~ BACKGROUND 1074 ;-:.~. CttRONOI.OG¥ .................. 1075 ~ ~ Srr~o~ ........ 107"/ AT ~IJE ............................. 1081 OtrIXOOK .......................... 1083 BmUOGRAPHY ................. 1084 THE Nl!x'r ST~ ................. 1085 TI31241620
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ENS AND TOBACCO 1067 1074 1074 1077 1077 1080 1082 • Is tobacco marketing the main reason why teenag- ers take up smoking? • Should youth-oriented tobacco marketing be sharply restricted? BACKGROUND Early Ad Campaigns Advertisers were quick to discern the value of appealing to the youth market. Health Warnings Mounting concern about the health consequences of smoking prompted government action. Teen Smoking Trends After dropping for 15 years, smoking rates among U.S. teenagers have begun to climb again. OmSFa'gr SITUATION Regulatory Proposals The Clinton administra- tion has proposed regula- tions governing the sale and distribution of cigarettes and smokeless tobacco products to young people. Spotlight on Smoking Recent scientific studies and news reports have trained the media spot- light on teen smoking. Blacks' Smoking Drops Far fewer black teem smoke than white teens, and researchers want to know why. 1083 1075 1078 1069 1076 1081 1084 1085 COVER~ © RENEE BOUCHARD PHOTOGRAPHY OUTLOOK Experience suggests that aggressive anti-smoking campaigns are not always effective. SIDEBARS AND GRAPHICS Chronology Key events since the 1920s. Showdown ,in the Tobacco companies are facing a new class-action suit. Joe Camel Under Attack No cigarette ads aggravate anti-smoking activists as much as the ones featuring this cartoon figure, Teens at Risk Even If They Don't Inhale Users of tobacco risk several forms of cancer. At Issue Should the government restrict the advertising, promotion, distribution and marketing of cigarettes to teenagers? FOR RJRTIt Bibliography Selected sources used. The Next Step Additional articles from current periodicals. Researcher ( Dec. 1, 1995 Volume 5, No. 45 Sandra Stencel ~GING EDITOI~ Thomas J. Colin AS~OO~TE EDITOI~ Sarah M. Magner Richard L Worsn0p ST~'~ Wmmts Charles S. Clark Mary H. Cooper Craig Donegan Kenneth Jost Tonya HaMs Congressional Quarterly Inc. ClIMB, MAN Andrew Barnes Vitro CrIMP, MAN Andrew P. Corty EDITOR AND PUBtICHEg Nell Skene EXECUTIVE EDITOR Robert W. Merry AS$OCIA~II PUBLISHER Edward S. Hauck Copyrtgh! 1995 Congre~,sional Quu~erly Inc.. All Rights Rt.'~erved. CQ dt~2s not convey an.'," license. nght. lille (Jr interest in any informalmn -- includ- Ing int'ormatton provided to CQ ftX~l~ third partte:~ -- Irln.~mttted via any CQ publication or elc.ctrontc transmission unless previously specifmd in INn pan of any CQ publication or transmission may be republished, reproduced, transmitted, down- Ityartt.vJ or dismbuted by any n~..an.~ whether elec- tronic or mcchani~.-ai without pnor wnttun permis- sion of CQ. Unaulhonzcw.I reprtxlut.xion or trJn.s- mission of CQ copyrighted material is a rio|alton of federal law ~.-arn.'mg ¢i,'il fines of tip to $ I(XI.(NX) and sertot,~s cnmlnal saner ons or in'tprlsonmt..nt. Bibliographic records and abstracts included in The Next Step seetion of this publication are from UMI's Newspaper and Periodical Abstract.: database, and are used with perrtnssion. The CQ Researcher ([SSN 1056-2036). Formerly Editorial Research Reports. Published wt:ekly t48 times per year, not printed the fir:~t Friday of any month with five FrKJays) by Cungrt.'s- stonal Quarterly Inc.. 1414 22nd Sl.. N.W.. Wa.~h- ington, De. 20037. Rates ate furnished upon requesL Second-class postage paid at Washing- lion, D C. PO$'I~rASTER: 5end address changes to The CQ Researcher. 1414 22nd St.. N.W.. '¢':L, thington. D C 20037. 1066 TI31241621
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Teens an 0bacc0 1~ t{ICtP, RD L WOP~NOP THE ISSUES Tobacco companies and public health specialists rarely see eye to eye on anything, but the issue of teen smoking makes both sides see red. "The problem is. the only people starting to smoke these days are kids," says John P. Pierce, a professor of family and preventive medicine at the University of California-San Diego (UCSD} and co-author of a recent study on the effects of cigarette adver- tising on young people. "The industry. clearly needs newcomers or they're going to go out of business. They've got to be targeting kids. Whether they intend to or not, they've got to focus on them because that's their source [of future smokersl." "R.J. Reynolds Tobacco Co. believes firmly in its long-held position that 'Kids should not smoke,' " the com- pany said in a brief statement issued last month. "We stand behind our position by offering programs that supplement other youth non-smoking efforts in schools, at retail [outletsl and in the home. These programs ... re- flect the many studies that show the key factors affecting youth smoking to be the influences of peers and family." The interest in teen and even pre- teen smokers is easy to understand. Sit,d- ies show that 80 to 90 percent of U.S. smokers started before age 20. The to- bacco industry needs a steady flow of young recruits to replace adult smokers who die or quit. By the same token, anti- smoking groups realize that their dream of a "smoke-free .~aerica" will remain just that unless teenagers c-an be per- suaded to abstain from tobacco. For a 15-year period starting in the mid-1970s, the anti-smoking forces seemed firmly in command. From 197"7 to 1992. the percentage of high school seniors who smoked one or more cigarettes a day dropped from 28.9 percent to 17.2 percent, l Even more remarkably, the daily smoking rate for African-American seniors fell from 26.8 percent in 1976 to only 3.7 percent in 1992. (See grapbs, p. 1068.) Now. however, the pendulum has begun to swing the other way. Over the past three years, tobacco use has increased among both white and black teenagers. And though smoking rates for both groups remain well below mid-1970s levels, public health offi- cials are worried. Of particular concern are data showing that the proportional increase in adolescent smoking is greatest among eighth-graders -- 13- and 14- year-olds. Between 1991 and 1994, the percentage of eighth-graders who smoke rose from 14.3 percent to 18.6 percent ~ a 30 percent increase over- all. Only about half of all eighth-grad- ers believe smokers run a great risk of harming themselves by smoking a pack or more daily. (See grapba; p. ~070, ~072.) Researchers cite a variety of reasons for the upsurge in teen smoking. -In addition to their unrealistically low per- ception of the dangers of smoking, there has been a dear weakening of peer norms against smoking," said Lloyd D. Johnston, program director of the Moni- toring the Future Project at the Univer- sity of Michigan's Survey Research Cen- ter. "While the majority [of teens] still say they disapprove of regular smoking, that proportion has been declining steadily since the early 1990s." -' Johnston also pointed to the to- bacco industry's advertising and pro- motional efforts: "Cigarette smoking is continually associated with social suc- cess, sexual attractiveness, a healthy demeanor, exciting sporting activities, a cool and tough image for the boys. a slender body and liberated spirit for the girls, autonomy and independence for both sexes. What else could an American adolescent want?" -~ The tobacco industry, for its part. vehemently denies that its advertising targets teenagers. It argues that ciga- rette ads seek to sway adult smokers who are considering switching brands. "If you're a non-smoker, the mes- sages in cigarette ads mean nothing to you," says Thomas Lauria. a spokes- man for The Tobacco Institute, the industry's trade group. "But if you're a smoker, and you find out from ads that a brand costs 25 or 50 cents a pack less than the one you're using, or it's got more flavor, less tar, you might decide to switch. There's a whole array of product attributes that is communicated through advertising." Anti-smoklng groups stress the health risks of tobacco use. but they have a further concern as well ~ that teenage smokers will experiment with marijuana and other illegal drugs. Indeed. recent survey data indicate marijuana use by teenagers has been rising along with cigarette use. ' That's why tobacco is called a "gate- way drag," says John F. Banzhaf III. executive director of Action on Smok- ing and Health (ASH), a Washington- based group that seeks to protect the ~ 1, 1995 1067 TI31241622
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IENS AND TOBACCO ~e ~ge of b~gb scb~l ~iom who ~ o~ or ~ ~ga~ a ~y b~ ~ ~ng st~.~2. ~y " smoMng ~ ~ ~ a~ng b~ck stu~, wbo f~ theft 15 ~m ha~ ~ far ~ l~y to s~ than wbi~. SmoMng a~ng all $~m ~ ~11 ~low what a ~ ~ ~ ago. "' ~ " f~~t,~~ 35 who smoked daily 35 Percentwho smoked daily 35 Percent who smoked dah'y 'I~ Percent 1~ ... Females Source: Uni~ity of Michigan Sum~ Reseamh C~t~ Monitoring the Future P~ject, 1995 rights of non-smokers. ~ Tobacco acts as a gateway "in a number of senses," Banzhaf adds. "For most kids, it's the first illegal drag they use. By illegal, I mean it is against the law for a 12-year- old to buy and use cigarettes, just as it's illegal to buy and use alcohol -- to say nothing of mariiuana, cocaine and heroin." lte makes the further point that "very few people can light up a mari- juana cigarette and take a deep drag if they've never smoked tobacco." Another cause for alarm about teen smokers. Banzhafsays, is that "the earlier they start, the more likely they are to become addicted, and to remain ad- dicted." Moreover, teenagers" bodies "are undergoing changes; they're still growing and developing. Exposure to any toxin is more likely to damage a lO- ot 12-year-old, whose body is still de- veloping, than a 21-year-old. whose body is pretty well formed." To minimize teenagers' exposure to tobacco marketing, the U.S. Food and Drug Administration on Aug. 10 pro- posed regulations governing the sale and distribution of cigaretms and smoke- less tobacco products (snuff and chew- ing tobacco) to children and adoles- cents. Among other things, the rules would prohibit cigarette vending ma- chines, free samples, mail-order sales and self-service displays; limit cigarette advertising in youth-oriented publica- tions to a black-and-white, text-only format: and require tobacco companies to ,set up and finance a $150-million-a- year public education campaign to warn teenagers about the hazards of smok- ing, The tobacco industry and advertis- ing trade associations have filed sepa- rate lawsuits seeking to overturn the FDA proposals (seep. 1072). At the same time, the tobacco in- dustry is under renewed assault in the courts. Sixty prominent personal- injury law firms from across the country have banded together in the largest product-liability suit in U.S. history. Filed in New Orleans on behalf of one de- ceased and three living plaintiffs, the suit could eventually embrace as many as 90 million current and former smok- ers. Four states, meanwhile, have sued tobacco companies seeking reimburse- ment for publicly" funded health-care oudays linked to tobacco-related ill- nesses. (See story, p. 1078.) History would not seem to be on the plaintiffs' side in any of the court cases. In more than 40 years of tobacco prod- uct-liability litigation, cigarette makers never have had to pay damages to any plaintiff. However, leaked tobacco-com- pany documents that have surfaced in recent years may present problems for the defense in the pending round of cases. The reason is that many of the documents seem to contradict or under- cut public statements by company offi- cials about tobacco's addictiveness or the industry's ability to manipulate the nico- tine content of cigarettes. ~ Still more internal papers are expected to surface as the suits enter the discovery phase. No verdicts or settlements are likely for at least several years, giving smok- ers and non-smokers ample time to ponder the controversy. These are some of the questions being asked: Is tobacco marketing the main reason why teenagers take up smoking? Down through the years, the slo- gans echo: "Reach for a Lucky Instead 068 ~ uet~tmk-r TI31241623
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Joe Camel Under Attack Homely yet suave, Joe Camel rivals Bugs Bunny and Donald Duck for cartdon name and image recog- nition. Since R.J. Reynolds Tobacco Co. made Joe the centerpiece of an ad campaign in 1988, the company's fading Camel brand has become one of the most popular cigarettes among young smokers. Adolescent boys, in particular, are said to view Joe Camel as cool, macho and self-assured -- the very. traits that many male teenagers fear they lack. Anti-smoking activists were not amused. In 1992, numerous public health groups petitioned the Federal Trade Commission to declare Joe Camel unfair advertising because he appeals to an illegal market -- smokers under age 18. But the commission voted 3-2 in June 1994 not to bar Joe from Camel ads, saying there was not enough evidence to prove he actually causes young people to start smoking. Anti-smoking groups still view Joe Camel as a public- health menace, however. To buttress their case, they point to a 1991 study suggesting that even very young children recognize the cartoon character. Children ranging from :5 to 6 years old were asked to match each of 22 brand logos displayed on cards to one of 12 products pictured on a game board. Ten logos were from children's products, seven from adult products and five from cigarette brands. Researchers found that Joe's recognition rate ranged from 30 percent among 3-gear-olds to 91 percent among 6-year-olds. t Anti-smoking groups say cbildren are targeted ~. ads for Camel cigarettes featuring Joe Camel. "By the age of 6," noted a 1994 U.S. surgeon general's report, "the face of ... Joe and the silhouette of Mickey Mouse (the logo for the Disney Channel on cable television) were equally well recognized." : Joe's popularity among youths doesn't stem solely from his aloof and enigmatic mien. Young people respond also to the line of Joe Camel merchandise featured in the Camel Cash catalogue, which many retailers distribute for free. The products include ball caps, tank tops, gym bags, denim or suede jackets, sunglasses and cigarette lighters. All may be obtained only in exchange for a stated number of notes," one of which is tucked int6 every Camel cigarette pack. Other cigarette brands mn similar promotions. But no cigarette ads aggravate anti-smoking activists as much as the ones featuring Joe Camel. As Mark Pertschuk, a spokesman for Americans for Nonsmokers' Rights, told the Los Angeles Times: "It doesn't take a Ph.D. to tell you that cartoon characters on skateboards are not targeting 35-year-old professional women." ~ t P.M. Fischer. et al.. "Brand Logo Recognition by Children Aged 3 tu 6 Years: Mickey Mouse and Old Joe the Camel," Journal of the American MedtcalAssociation. Dec. 17, 1991. pp, 3145-3148. AlSo *ee, ~Adverttsing tinder Attack." The C.Q Researcher, Sept. 13. 1991. pp. 657-680. ~ U.S. Department of Health and Human .Services. PrevenltnR "l'obacco Use Among l'bung PeopLe: A R~{port of the Surgeon General (1994). p. 191. sLos A~lgele.¢ Tirade.. Aug. 21. 1995, p. A14. The group is based in Berkeley, Calif. of a Sweet"; "Blow Some My Way": • 'I'd Walk a Mile for a Camel": "You've Come a Long Way, Baby." These catch phrases, some of the best known in U.S. advertising his- tory. all were designed to promote a particular brand of cigarette. Sales figures and independent research stud- ies suggest that ad campaigns have helped boost cigarette consumption generally. Even so. opinion remains split on whether cigarette ads play a decisive role in persuading persons under age 18 to smoke. Cigarette companies contend the answer cleady is no. "Finland banned all tobacco advertising in 1978," says Lauria at The Tobacco Institute. "'Even so, their youth smoking rate stubbornly stayed the same and then recently went up. I can't explain why that is the case, although I do logically point out that if advertising is such an influence that would have been impossible." The tobacco industry spends bil- lions on advertising and other forms of promotion for a simple reason. Lauria adds: ~Brand imagery is closely associated with advertising, because cigarettes are very similar to one another." Moreover, he notes, smok- ers carry their cigarettes with them. typically taking a pack out of a pocket or purse before lighting up. "Other people notice that. Brand identifica- tion is not irrelevant to a smoker." If cigarette advertising has minimal impact on non-smoking adolescents. what does impel them to take up the tobacco habit; ~The overwhelming pre- ponderance of data on why non-smok- ing teens start smoking focuses on peer T!31241624
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L ENS AND TOBACCO .Attitudes Toward Smoking Only about half of all eighth-gradem believe smokers run a great risk of harming tbermelvea by smoking a pack or more daily. : 100 80! 60 4O 20 0 Percent Who Perceive Great Risk _ 12th-graders ...........------- - - 10th-grader~ 8th-graders 100 8O The vaat majority of teens disapprove of people smoking one or more packs a day, but disappmt~l ratings have dropped in recent yearx. Percent Who Disapprove 6O 4O 2O stu.~ 10m-graders i t t t t 0 t t 1991 1992 1993 1994 1991 1992 • Source: University of Michigan Survey Research Center, Monitoring the Future Project. 1995 1993 1994 pressure." Lauria says. "If anybody else told you lthat] but the tobacco compa- nies, it would be taken as gospel. But anti-smoking activists, in their statist zeal. prefer to attack the industry -- as op- posed to being perplexed by the intri- cacies of human behavior." Banzhaf of ASH attributes the recent rise in teen smoking rates to "a tremen- dous increase in the amount of promo- tional material" distributed by tobacco companies. "Not advertising -- promo- tion." Banzhaf emphasizes. "Most of the [marketing] money is now going into promotion, not direct advertising." Promotion includes such things as free samples, price cuts, sponsorship of sports events and marketing of apparel and other items popular with teenagers in exchange for a stated number of empty cigarette packs. "Kids get a desire to own one of these promotional products." Banzhaf says. "Even if they don't smoke, they get in the habit of handling the packs, ask- ing people to give them [emptyl packs and so on. That tends to break down the aversion [to smoking]." According to a study" published in August 1994 by the U.S. Centers for Disease Control and Prevention (CDC), teenagers are significantly more re- sponsive to cigarette advertising than are adults. In 1993, the study noted. Marlboro. Camel and Newport were the three most heavily advertised ciga- rette brands. While the three brands accounted for 35 percent of total ciga- rette sales that year, they accounted for 86 percent of cigarette purchases by adolescent smokers. The study acknowledged, however, that "ciga- rette sales to adolescents constitute a small percentage of the total market."" A more recent study, published this October. concluded that advertising is the dominant influence in persuading teenagers to use cigarettes, a "Tobacco marketing is much stronger than peer pressure in getting a youngster to take the first step toward smoking," said UCSD's Pierce, a co-author of the study. "It is what starts adolescents down the slippery slope to addiction_" ~ At the end of elementary school, Pierce said, children "are adamantly anti- smoking." But then "their resolve weak- ens over the next couple of years, and the}, start experimenting. We're arguing that tobacco marketing primes the pump, starts the whole process going." Pierce hastened to add that peer pressure also is a key influence. "We found that you're more likely to be at risk to start smoking if you have other smokers in your family or among your friends," he said. "So we're not saying [peer pressure isl not important. It is important; it's important all the way through [adolescencel. But in the early stages, marketing seems to be more important ." In conducting the study, Pierce and his fellow researchers asked more than 3,500 non-smoking California adoles- cents a set of yes-or-no questions about cigarette advertising; the objective was to gauge susceptibility to future to- bacco use. More than half the children said they v-ere familiar with some ciga- rette brands and ads. and about one in TI31241625
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five wanted to own a promotional product offered by a tobacco company. On the basis of these and other re- sponses to survey questions, the re- searchers concluded that, "Overall, one-quarter ... of adolescent never- smokers were susceptible to smoking," t0 According to the study, adolescents exposed to fam- ily members or peers who smoked were almost twice as likely as others to begin smoking themselves. But even when peer influence was taken into account, teens deemed receptive to cigarette ads were found to be two to four times more likely to land in the smoking-susceptible group than were those clas- sified as unreceptive. Survey data showed that ads for Camel cigarettes were more popular by far among teenagers than those for any other brand. Sales data sug- gested that the Joe Camel marketing campaign, which started in 1988, was largely responsible. (See story, p. 1069.) "In 1987, Camel ciga- rettes were virtually invisible in the illegal teenage market," the study stated, "However. 18 months later, Camel cigarettes had acquired a market share of 8.1 percent, and national data from 1993 indicate that these cigarettes now represent a 13.3 percent share of the adolescent market." ~1 Lauria at The Tobacco In- stitute dismisses the California study as "political science" that "was just manufactured as fodder for the FDA's proposed curbs" on cigarette ads the agency feels are aimed at teens. The stud}, was "skewed to force-feed im- pressions on children and then ask them quickly for a yes or no" re- sponse, he contends. For instance. Lauria notes that the children were asked whether cigarette ads convey the message that successful people smoke. "Well, successful people do smoke," he says. "You can see David Letterman with a cigar or Christian Slater and Winona Ryder with a cigarette m Anti-smoktng adtz, r~isement frora the ,Vational P'E,4 and m,.ore than 100. otber groups urge~ support for proposed timfts on raarketing tobac¢o products to children. and they're not posing for ads, either. We don't use celebrities in cigarette ads; that hasn't happened in decades. But successful people smoke in real-life situations, and an observant kid will notice that." In this connection, Banzhaf cites an apparent increase of smoking scenes in movies and television shows. "There was a period in the late 1970s and "8Os when smoking almost disappeared from films," he says. "But now it seems to be making a comeback. You see smoking not just when it's essential to the scene, or when only the bad guys are lighting up. Increasingly, you're seeing the hero and the hero- ine or other sympathetic char- acters puffing away in situa- tions where smoking very clearly does nothing to ad- vance the plot." Johnston at the University of Michigan says he "strongly suspects" that product place- ment explains the increase in smoking scenes. "The other night, I saw "Get Shorty,' with John Travolta," he says. "I don't think there was a scene in the entire movie that didn't have at least one person smoking, and sometimes more. Actually, Travolta may be trying to rebuild his career around the smoking charac- ter. I don't think he ever was shown without a cigarette in "Pulp Fiction,' either. So, he alone is a one-man disaster for teenage smoking." Lauria says there was "ab- solutely no product place- ment" by cigarette companies in "Get Shorty." "Pulp Fiction" or "any other movies made in recent memory." That's be- cause the practice was ended by industrywide agreement in 1990. "So if there have been more smoking scenes in the last five years, it has to do with creative license, not dustry placement." Should youth-oriented tobacco marketing be sharply restricted? Disturbed by the recent rise in ado- lescent smoking, President Clinton on Aug. 10 announced he was taking steps to counteract the trend. The action took the form of proposed FDA regulations to curb marketing of toi~acco products l)eeemberl, 1995 1~1 TI31241626
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ENS TOBACCO Teen Smoking on the Rise The increase was greatest among eighth-graders, who are 13 and 14 years old. +30% +10% +22% . 20.8 ~ Source: UniversiO, of Michigan Survey Research Center. Monitoring the Future Project. 1995 to youths under age 18. "When Joe Camel tells young chil- dren that smoking is cool. when bill- boards tell teens that smoking will lead to true romance, when Virginia Slims tell adolescents that cigarettes may make them thin and glamorous. then our children need our wisdom. our guidance and our experience," Clinton said. -We're their parents, and it is up to us to protect them." ~z The FDA proposal, issued the same day, would (1) make 18 the federal minimum age for buying tobacco prod- ucts; (2) prohibit cigarette vending machines, free samples, mail-order sales and self-service displays; (3) re- quire retailers to verify the age of young purchasers: f4) limit tobacco product ads and labels to which chil- dren are exposed to text-only "tomb- stone" formats; (5) bar the sale or dis- tribution of non-tobacco promotional items beadng brand names: (6) require tobacco companies sponsoring events such as sports tournaments to identify themselves by" corporate, not brand, name; and (7) make the companies establish and fund an ongoing public education campaign to discourage young people from smoking, t~ FDA Commissioner David A. Kessler said the agency had regulatory authority over cigarettes, since they are medical "devices" under the terms of the Fed- eral Food, Drug and Cosmetic Act. Not surprisingly, the teen-smoking initiative won plaudits from many scientists, public health officials and anti-smoking activists. "No serious scientist questions the fact that to- bacco is the single greatest prevent- able cause of cancer in the United States," said National Cancer Institute Director Richard D. Klausner. He described Clinton's decision to permit FDA regulation of tobacco products as "without a doubt the most important thing in public health that he will do in his administration." t~ Johnston also hailed the FDA pro- posals, saying they "'would certainly move us in the right direction to re- duce the amount of advertising and promotional materials that reach young people. They would remove some of the strongest stimuli that encourage adolescent smoking." But while "reducing easy access to cigarettes is iml:x)rtam," Johnston feels the chief value of the FDA role package lies in "'the symbolic message it sends. It says that we really do ~.~are as a s(x:iety about whether our kids smoke, and that we don't want them to." He adds, "When kids have this product pushed in their face in virtually every comer of the coun- try, it sends them another kind of mes- sage ~ "Tobacco must not be all that bad. because if it were, adults would protect us from it.' In fact, I've heard youngsters say exactly that." As was expected, cigarette makers strongly condemned the FDA's pro- posed rulemaking, portraying it as the In'st step in a campaign for prohibition of tobacco products. Indeed, tauria goes 1072 q2~ TI31241627
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so far as to call the agency's action "an illegal and unconstitutional power grab" by Commissioner Kessler. "FDA hasn't got jurisdiction here," Lauria says. "They never did have jurisdiction here, and if Congress" will prevails, they'll never have jurisdiction." In a joint motion for summary judg- ment filed Oct. 4 in U.S. District Court in Greensboro, N.C., the five leading cigarette manufacturers" and a North Carolina advertising agency sought to block imple- mentation of the FDA roles on the grounds our|ned by Lauria. ~On at least 20 differ- ent occasions Congress has rejected legislation that would have granted FDA jurisdiction over cigarettes," the plaintiffs declared. "On each occasion -- including at least seven times over the last decade m , Congress has decided that FDA should have no such authority." , The advertising industry. which numbers tobacco com- panies among its top clients. : also seeks to defeat the FDA rules package in court. In a complain[ filed Sept. 27. six : major advertising groups'" echoed some of the same ar- guments embodied in the cigarette makers' plea to the same court. But the advertis- ers also contended that the FDA regulations would viohue their First Amendment rights, "'The objective of the Fr)A's a.~ertion of jurisdiction over the advertising of cigarettes and smokeless tobacco products is not to • The ctmtlXime~, are Brim n & Williams~m Tobacco Corp.. LLt~g~tt Group inc., I.ordlard T¢:,ba¢¢o Co. Philip Morris Inc. and RJ Reynolds Tobactx~ °*The groups art: the Am~'rtt-an Adverltslng A~c~at~m ot A~rg-a a~ create restrictions or conditions so that cigarettes and smokeless tobacco prod- ucts can be used safely and effectively," the complaint stated. "The objective... is to reduce underage tobacco use by curtailing speech." The advertisers fur- -ther charged that the FDA's move qs causing substantial irreparable injury to plaintiffs by chilling their constitution- ally protected speech." Without judicial HOW TO TALK TO YOUR KIDS ABOUT SMOKING BEFORE SOMEONE ELSE DOES. ..k w rtisemt nt from th~ R. J. R¢ ~ noMs Tobacco Co. offi m pam~lts a free 12-page b~hu~, and )bulb &lucation Kit to "'help them ta& to their ki¢~ a~ut smoking. '" relie£ "plaintiffs will face continued and len~hy unce~inty in entering into con- tm~ and making Mtum editorial deci- sions re~rding adve~ising of tomato pr(~ucts." Daniel L. Jaffe. executive vice presi- dent of the Association of National Ad- vertisers, says the FDA rulemaking notice is "the m~st restrictive proposal in t~- histo~ ~ this count~ with ~- gard to advertising.~ Advertisers "have no position on whether people should smoke, or whether tobacco should be allowed to be sold or not sold." he says. "Our position is very simple: We believe that if tobacco is a legal prod- uct, which it is, it should be allowed to be advertised in a free society. That's what the First Amendment is all about. And while we agree the government should have authority to pro- tect children, we feel it has gone way beyond that legiti- mate goal by trying to impose restrictions that would make it virtually impossible to ad- vertise to anybody." Jaffe predicts that the pro- posed advertising curbs "will create enormous precedents that will impact not just the tobacco companies but mak- ers of any other controversial products," citing high-fat or high-salt foods as potential examples. He adds, "If we use children as the litmus test for what can he expressed through advertising in our so- ciety, then we are going to lower public discourse to the level ()f the sandbox." The g()vemment, in Jaffe's view. is approaching the youth smoking issue from the wrong directh)n. "We don't stop advertising alcohol, cars or guns hecause they might fall into the hands of under- age users," he says. "Instead, we restrict their sales. If gov- ernment cracked down on il- legal tobacco sales at the point of purchase, that would do more to reduce teen smoking than any con- ceivable restriction on advertising." Elizabeth M. Whelan. president of the Amerit~an Council on Science and tteahh, a consumer advocacy group in New York, devotes much of her time to what she c-alls the "cigarette tragedy." But as a cnn.~rvative Re- puhlican, she feels the prolx~-d FI)A Dectmber 1, 19~)5 1073 T!31241628
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TOBACCO regulations are misconceived and heavyhanded. In her view, the best way to discourage smoking within all age groups is to make tobacco com- panie.s play by the same liability rules as other industries. The best way to do this, she says, is to have Congress remove the government-mandated warning labels from cigarette packs. "tAls a result of the label, tobacco- company lawyers have consistently and successfully argued in court that Congress has pre-empted their respon- sibility for warning consumers about any diseases that cigarettes might cause." Whelan noted last year. "If we were truly serious about confronting an industry that is literally selling death, we would remove the govern- ment warning label and thus strip the tobacco industry of this privileged legal status." is If the shield were lifted, Whelan says in a recent interview, the tobacco indus- try itself would have to inform consum- ers in detail about the health conse- quences of smoking. That would mean, in turn. that warning labels on cigarette packs "would be about the size of the New York City phone book." • BACKGROUND Early Ad Campaigns l~/l" ost people don't realize how new the cigarette is," Whelan says. Before the 19th century, the lead- ing tobacco product was snuff-- pow- dered tobacco that could be inhaled through the nostrils, chewed or lodged between the inner lip and gums. To- ward the middle of the century, smok- ing of pipes and cigars increasingly gained favor. And as the 20th century neared, cigarettes began their ascent to the pinnacle of the tobacco market. Tobacco companies realized early on that promotion of brand names was crucial to building market share. In 1866, for example, W.T. Blackwell and Co. of Durham, N.C., introduced the Bull Durham brand of cut tobacco. A decade later, Blackwell partner Julian Cart launched a nationwide advertising campaign "in which the Durham Bull itself, rather than the tobacco, was portrayed in anthropo- morphic situations, alternating be- tween scenes in w, hich the bull was jovial and boisterous and those where he was serious and determined." Cart was also quick to discern the value of appealing to the youth market. To this end, he had Blackwell's sponsor the 1879 commencement exercises at the University of North Carolina in nearby Chapel Hill. Guests were taken "from hotel to campus with a livery of horses, each of which had attached to it a flag beating the sign of the bull; the wagons dealt with the matter more directly -- they had painted on them the sign "Smoke Blackwell's Durham Smoking Mixture.' " Another cigarette marketing prac- tice of the period -- inserting a pic- ture of a scantily clad woman in each cigarette pack-- sparked hostile com- ment. This -early use of "soft pornog- raphy" as the basis for product promo- tion was reported to have had young boys scrambling after cigarette packs." John Pierce and Elizabeth A. Gilpin wrote in a recent historical study of tobacco marketing. "There was wide- spread consternation with what was perceived to be a powerful corrupting influence of the cigarette industry on young boys." Is World War 1 is credited with fur- ther popularizing cigarette smoking by young men. since free or cut-rate cigarettes were distributed to armed forces personnel. Aher the war. ad campaigns began targeting young women as well. For instance. Ameri- can Tobacco Co.'s famous "Reach for a Lucky Instead of a Sweet" slogan reinforced the notion ~ still preva- lent today ~ that smoking makes it easier to keep a trim figure. Many adults, meanwhile, were growing uneasy. As a 1994 U.S. sur- geon general's report noted, "From the time of the earliest marketing campaigns, parents, educators and policy-makers worried about the ex- posure -- intentional or not, it was inevitable D of young people to ciga- rette advertising." 19 But the cigarette ad blitz only grew heavier with the advent of nationwide radio broadcasting in the 1930s. Then and later, tobacco companies spon- sored numerous musical radio pro- grams popular with teenagers. The longest-running program of this kind was "The Lucky Strike Hit Parade," which started in 1928 and ended on television in the 1950s. "So popular was this show in 1938," stated the surgeon general's report. "that when its producers introduced a sweep- stakes promotion offering free cartons of'Luckies" for correctly guessing each week's three most popular tunes, the promotion drew nearly 7 million en- tries per week." .,,i Health Warnings Anew generation of young fight- ing men was introduced to smok- ing through free and discount ciga- rettes during World War 1I. After peace returned, civilian cigarette sales re- sumed their climb. During the 1950s, though, medical authorities began to warn of the health hazards of smoking. The American Cancer Society adopted a resolution in 1954 to ~emphasize to the American people that ... presently available evi- dence indicates an association between smoking, particularly cigarette smoking, and lung cancer." Three years later, Surgeon General Leroy E. Burney as- serted that "the weight of evidence is increasingly pointing in one direction: Couhmwd o~ p 1076 TI31241629
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Chro logy 1920s-1930s Cigarette advertising flour- ishes in the interwar perio~ with numerous ad campaigns appealing to young men and m for the first time m young wometL 1926 Ads for Chesterfield cigarettes show a young woman saying, "Blow Some My Way." The at- tempt to make smoking acceptable to women sparks public outrage, but other tobacco companies launch similar campaigns. 1928 Lucky Strike sponsors "The Lucky Strike Hit Parade," a weekly musical radio show popular with young people. The "Hit Parade" successfully makes the transition to television after World War lI before leaving the air in the 1950s. I930s During the heyday of the Big Band Era, cigarette companies sponsor weekly radio shows featuring Benny Goodman, Glenn Miller. Attic Shaw. Tommy Dorsey and the Andrews Sisters. 1950s-19 70s Mounting concern about the health consequences of smok- ing prompt action by the federal government. 1954 The American Cancer Society adopts a resolution to "emphasize to the American people that ... available evidence indicates an association between smoking, particularly cigarette smoking, and lung cancer.~ Three years later. Surgeon General Leroy E. Burney asserts that "the weight of evidence is increasingly pointing in one direction: that excessive smoking is one of the causative factors in lung cancer." Jam 11, 1964 Surgeon General Luther L. Terry" issues a report, Smoking and Health, stating that the death rate from lung cancer for male smokers was 10 times higher than among non-smokers. It'also says cigarette smoking is "the most important" cause of chronic bronchitis, emphy- sema and coronary heart disease. April 27, 1964 Nine leading tobacco manufactur- ers unveil an advertising code aimed at restricting ads that target consumers under 21 or that con- tain unsupported health claims. 1965 President Lyndon B. Johnson signs the Federal Cigarette Label- ing and Advertising Act, which requires a health warning on all cigarette packages. The law is tightened in 1969 and 1984. 1971 All cigarette commercials are barred from radio and televi- sion. Public service messages warning against the health hazards of smoking soon leave the air as well. 1977 Cigarette smoking by U.S. high school seniors, as measured by the University of Michigan's ongoing Monitoring the Future Project, begins a decline that is to last 15 years. 1980s-1990s The ongoing struggle between the tobacco industry and anti- smoking groups grows still more intense. 1988 R.J. Reynolds Tobacco Co. launches its "Joe Camel" ad cam- paign for Camel cigarettes, revers- ing the brand's sales decline. 1992 Anti-smoking groups petition the Federal Trade Commission (FTC) to prohibit the use of the Joe Camel cartoon character in Camel ads. contending that it induces youngsters under 18 to smoke. May 12, 1994 Stanton A. Glantz, a professor of medicine at the University of California-San Francisco, receives some 4,000 pages of internal documents from the Brown & Williamson Tobacco Corp., sent by an anonymous source. June 7, 1994 The FTC confirms that it voted 3-2 a week earlier not to prohibit the use of Joe Camel in Camel cigarette ads. Aug. 11, 1995 The Food and Drug Administra- tion (FDA) publishes proposed regulations in the Federal Register that would curb tobacco advertis- ing and promotional activities directed at youngsters and re- quire manufacturers to establish a $150-million-a-year public educa- tion campaign to discourage children and adolescents from smoking. September-October 1995 Coalitions of tobacco companies and national advertisers file separate suits in U.S. district court in Greensboro. N.C.. seek- ing to block implementation of the FDA's rulemaking package. ~ I, 199~ 1075 TI31~41630
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TOBACCO Teens at Risk Even If They Discussions of teen tobacco use usually center on cigarette smoking. But teen consumption of smokeless tobacco ~ chewing tobacco and snuff ~ also disturbs public health officials. About 11 percent of high school seniors had used smokeless tobacco during the previous 30 days, according to a survey taken in 1994. ~ Chewing tobacco users lodge a wad of loose-leaf tobacco or a plug of compressed tobacco in their cheek; snuff users place powdered or finely cut tobacco between the cheek or, lip and gums. In both cases, the user sucks on the tobacco and spits out the resulting brown juice. Studies have shown that the blood of adult smokeless-tobacco users has nicotine levels comparable to those found in smokers. Consumption of smokeless tobacco varies by region ~ it's lowest among teens in the Northeast and highest in the South and North Central region. Indeed, a 1994 report on preventing nicotine addiction in children and youth noted that smokeless tobacco use by teens exceeded the youth smoking rate in several states, including Alabama, Colorado, Idaho, Montana. South Dakota and Wyoming. = According to a 1991 study, high school boys who dipped snuff or chewed tobacco often engaged in other types of risky behavior. The survey found that boys were more likely to report use of smokeless tobacco if they rarely or never wore auto seat belts, frequently got into fisffights. carried a weapon during one or more of the preceding 30 days, used anabolic steroids without a doctor's prescription or had made one or more suicide attempts in the preceding 12 months. * Some stltdies have found a link between the use of smokele.~s ~obacco and participation in team sports. ~ But according to a 199,~ U.S. surgeon general's report, "current studies have mixed findings about this possible relationship .... Taken together, the current evidence is inconclusive and warrants further investigation tlmt might consider team rules regarding smokeless tobacco use, coaches' use of smokeless tobacco or attitude toward team members' use and parents' degree of involvement in the team." ~ Regardless of their individual behavior profiles, all smokeless tobacco users expose themselves to serious health disorders. In 1992, the Department of Health and Human Services (HHS) reported that the chief hazards for young dippers and chewers were nicotine dependence, bad breath. receding gums and leukoplakia -- a white patch that forms Don't Inhale on soft oral tissue and cannot be scraped off. Longterm users tun the risk of developing cancers of the gum, mouth, larynx, pharynx and esophagus. ~ Several studies have found that smokeless tobacco use is a risk factor for cigarette smoking, and vice versa. As one report noted, =The exchangeability of tobacco use supports the idea that nicotine addiction can be maintained by tobacco from any" source."7 The best-known adolescent victim of smokeless tobacco was Scan Marsee, a star high school athlete from Oklahoma who regularly dipped snuff. Marsee developed oral cancer as a result, and died in 1984 at age 19. The outcry over his death sparked a nationwide campaign to ~snuff out snuff." That obviously didn't happen, but regulation of snuff and chewing tobacco was tightened in 1986. Health warnings were made mandatory that year on smokeless tobacco packages and print advertisements. In addition, radio and television advertising of the products was banned, just as cigarette commercials had been forced off the air 15 years earlier. Sales of smokeless tobacco products declined in the late 1980s. By 1991, however, annual consumption in the U.S. had returned to its 1985 level of over 120 million pounds. According to the 1994 U.S. surgeon general's report, the increase in use coincided with an increase in advertising and promotional .expenditures starting in 1988. PromotRmal activities such as sponsorship of entertainment events ahd gifts given at the point of sale ~appear to particularly appeal to male adolescents, even if the smokeless tobacco industry does not explicitly target teens," the report noted. ~ 'Results relx~rted in the 1995 Monitoring the Future Project o[ the University of Michigan's Su~.e.v Research Center. : .See Barbara S. Lynch and Richard J. Bonnie, eds., Grou'mR L'p Tobacco Free: Pret~,ttting NicolD~e Addfction in Children and Youths (1994). p, 58. ~The 1991 Youth Risk Behavior Survey, conducted h.v the Division of Adolescent and School lteahh of the Centers for Disease Control and Prevenoon. " Ibid. • U.S. Department of Health and Human Services. Pre*~t, nti~ig Tobacco L'se AmonR Young People: A Report of the Surgeon General t1994|, p. lq4. ~The 1992 HHS report Spit Tobacco and )'bulb estimated that -tO to 60 percent of smokeless tobacco users develop gum recession and/or leukoplakia. "Lynch and Bonnie, op. c~t. Also see. U.$. Department of Ilealth "and Human Services, op. cir. ~ U.S. Department of Health and Human Services. op. cir.. p. 163,. Continucd fmra p. 107"t that excessive smoking is one of the causative factors in lung cancer." A historic turning point came Jan. 11, 1964, with the release of a long-awaited report by the Advisory Corrmaittee on Smoking and Health, appointed two years earlier by Surgeon General Luther L. Teay. The committee's key conclu- sion was that "Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action." The panel based its Finding on statistical studies showing that "cigarette smoking is causally related to t~ancer in men" and that "the magnitude of the effect of cigarette smoking far outweighs all other factors." Stung by" the report, the tobacco industry on Apdl 27 unveiled a volun- tary cigarette advertising code aimed TI31241631
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,( chiefly at ads targeting persons under 21 and unsupported health claims. The code stated that no advertising for newspapers, radio or television could be used until it had been cleared by the code administrator, who had au- thority to impose fines of up to $100,000 on any company found in violation of the rules. The regulations barred testimonials by famous ath- letes or entertainers with a 'special appeal' to younger people and banned cigarette ads from broadcasts or pub- lications meant for persons under 21. In 1965, Congress joined the fray over smoking and health by approving the Federal Cigarette Labeling and Advertising Act. The law provided that, as of Jan. 1, 1966, all cigarette packages and cartons sold in the United States and its possessions must bear the mes- sage, "Caution: Cigarette Smoking May Be ltazardous to Your Health." The requirement applied to imported as well as domestically produced cigarettes. * The tobacco industry suffered an- other apparent setback when the Federal Communications Commission (FCC). citing the "'fairness doctrine," in 1967 ordered broadcasting stations that carried cigarette commercials to make available a significant amount of time for anti-smoking announce- ments. As a result, thousands of mes- sages warning of the health hazards of smoking appeared on radio and TV over the next three and a half years. In 1969. cigarette sales fell by more than 12 billion -- a bigger drop than immediately :trier the release of the surgeon general's report. That same year. cigarette manufacturers proposed to end all broadcast advertising. I.egislation approved by Congress in 1970 gave the manufacturers" pro- posal the force of law, effective Jan. 2. 1971. Shortly thereafter, the FCC ° The Public Health Cig:~rette Smoking Act of 1969 ~md the Comprehensive Smoking Educatton Act of 1984 ",trengthened the health warning l'mguage. and a 1972 consent order of the Federal Trade Curm'm.ss~cm extended the ~'ammg tequtremenl to ruled that broadcasters need not con- tinue running anti-smoking messages. Teen Smoking Trends The percentage of high school se- niors smoking at least one ciga- rette a day slid from 28.9 percent in 1977 to 17.2 percent in 1992, accord- ing to data gathered by the University of Michigan's Monitoring the Future Project. The ,drop was even sharper among black youngsters, a trend that intrigues researchers on both sides of the smoking issue (seep. 1082). Many experts attributed the teen-smoking decline to the disappearance of broad- cast cigarette commercials. That theory seemed less persuasive after the Monitoring the Future Project reported that 19.4 percent of high school seniors were smokers in 1994. One reason for the turnaround, Johnston suggested, is that teens "greatly overestimate their ability to stop smoking once they have begun, so they are making decisions about whether or not to smoke at a very. early age, with little or no apprecia- tion of the likely consequences of those decisions." "~ Patrick M. O'Malley, a colleague of Johnston's. noted that even two years of increased smoking by teens will have lasting consequences. "We know that once a birth cohort establishes a particularly high or low rate of smok- ing in adolescence, relative to other birth cohorts, it continues to maintain a relatively high or low rate through- out the life cycle," he said. "Thus the higher rates that we are observing now are likely to remain high later in life for these children."-'-" Johnston foresees no "immediate reversal" of the current trend. "It's a little like the proverbial Lvattleship. "Ifll take time to make it change direc- tion. Also, we have to realize that kids entering the age groups we sup,'ey have already been subjected to years of persuasion by the tobacco industry." Whelan has first-hand knowledge of smoking patterns among high school seniors. "My daughter just graduated from a private girls school here in New York, and half of the 32 seniors smoked," she says. "I felt a sense of defeat, because these young women had been warned about the dangers of cigarettes since kindergarten. And even so, they smoke. What can I say?" Whelan acknowledges that the insis- tent warnings of anti-smoking activists may backfire among teenagers, who often resent adult authority figures. "My daughter once said to me, 'If I hear one more thing about smoking, maybe I should try it. There must be something great about cigarettes if you keep talk- ing about them that much.' " [] .Regulatory Proposals When President Clinton gave the FDA the green light to regulate tobacco marketing aimed at youths, he said smoking-related heahh haz- ards compelled him to act. "fClhildren are especially susceptible to the deadly temptation of tobacco and its skillful marketing," he declared at an Aug. 10 White House news confer- ence. "Today and every day this year. 3,000 young people will begin to smoke. One thousand of them ulti- mately will die of cancer, emphysema. heart disease and other diseases caused by smoking. That's more than 1 million vulnerable young people a year being hooked on nicotine that ultimately could kill them.~ The president conceded that a new TI31241632
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IENS AND TOBACCO Showdown in the Courts... In more than 40 years of battling product-liability lawsuits brought by aggrieved smokers, tobacco companies have compiled an impressive record. Not once in that period has any tobacco firm had to pay damages. ~ Anti-smoking groups contend the industry has prevailed because of superior legal firepower. With their deep pockets, these groups say, tobacco companies can afford to outspend and outwait most individual plaintiffs. The companies see things differently, contending that juries and judges have consistently found the defendants' arguments to be stronger. Now the anti-smoking movement has adopted a new, more broadly based litigation strategy. In February, lawyers representing more than 60 personal-injury law firms from across the country received certification from a federal cout~ in New Orleans to bring a class-action suit on behalf of the late Peter Castano and three living smokers who claim to be addicted to nicotine. Assuming the case goes to trial in the class-action suit, Castano v. American Tobacco Co. et al., could become the largest w and most expensive -- product liability suit in the nation's history, * The defendants have appealed the certification decision. Daniel W. Donahue, deputy general counsel for R.J. Reynolds Tobacco Co., estimates that oral arguments on the appeal will be heard early in 1996 and that an opinion will follow sometime in the spring. Meanwhile, the governments of four states -- Florida, Minnesota, Mississippi and West Virginia -- are suing cigarette makers to recover billions of dollars spent to treat Medicaid recipients for smoking-related illnesses. Maryland plans to file a similar suit early next year. If any of the state suits should succeed, others almost certainly would follow. John F. Banzhaf Ill, executive director of Action on Smoking and Health (ASH). feels more state cases may be filed in any event. "There could be an inadvertent boost from Congress, which is still considering so-called tort reform," he says. "So states may figure they can escape any restrictions the federal legislation may contain by acting now.~ ~ In Banzhaf's view, the significance of the Castano and state suits "is not limited to what may be won three to six years down the road." More important, he says, the suits ~are going to uncover tremendous amounts of documents" from the tobacco companies and ~put us in a position where our side can question the other side 'very completely under oath." Elizabeth M. Whelan. president of the American Council on Science and Health. has some misgivings about the state suits, qt can be argued," she says, "that if you don't smoke, start going downhill at age 90 and finally expire at 98, you cost the health-care system more than a heavy smoker who dies at 48." Whelan believes the states will have trouble combating that argument. The Castano class-action suit looks "much more promising," she feels, since the Supreme Court ruled in 1992 that the health warning labels on cigarette packs do not totally shield tobacco companies from liability. "If you can prove fraud and misrepresentation, a lawsuit could proceed even with the label in place." she says. ~And Castano is the first time l've ever seen financial resources for the plaintiffs that possibly match those of the tobacco companies." Anti-smoking activists regard the thousands of confidential tobacco company documents leaked to researchers and the news media in recent years as a rich source of evidence that tobacco companies deliberately suppressed or distorted findings that cigarettes constitute a health hazard. More than q,000 such documents, from Brown & Williamson Tobacco Corp., were sent last year by an unknown source to Stanton A. Glamz, a cardiologist at the University of California-San Francisco. federal regulatory program might strike many people as the wrong way to deal with the issue. Indeed. he said he "would prefer it if we could have done this in some other way." If Congress were to act. "this rule could become unnecessary. But it is wrong to believe that we can take a volun- tary approach to this problem." Asked by a reporter whether there was "any hope for some sort of com- promise" on the rulemaking, Clinton said he "had hoped that the tobacco companies would agree to support these restrictions and to put them into law." However. he said he opposed a voluntary plan because "there'd be no way to enforce it." According to Lauria, the industry has "never been invited to negotiate with the president. There has been no com- munication with the White House di- rectly by the tobacco companies." In his opinion. "President Clinton relies very heavily on the standard boilerplate of the anti-smoking activists. It's clear they have his ear and his mouth." And that's why the industry feels its "best recourse is in the court system, which, free from rancor, tends to evaluate complicated issues objectively." To Jaffe of the Association of Na- tional Advertisers. the "most outra- geous" segment of the Clinton-FDA regulatory package is the proposal to make the tobacco companies set up and finance a $150-million-a-year public information campaign to help curb young people's use of tobacco products. "In effect," Jaffe says, "the government is saying to the tobacco industry, "We will tax you and take your money and spend it on speaking against your product. We're going to let you be the one who funds speak- ing out against your product, even though we could ban your product if there was anything false or deceptive in your advertising."~ Supporters of the proposed regula- tions retort that the gmvi~, of the situ- TI31241633
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,.. Tobacco Companies Face Class-Action Suit The Journal of the American Medical Association (JAMA) devoted much of its July 19, 1995, issue to a detailed analysis of the papers. In the words of a JAMA editorial, *The documents show: • that research conducted by tobacco companies into the deleterious health effects of tobacco was often more advanced and sophisticated than studies by the medical community; o that executives at Brown & Williamson knew early on that tobacco use was harmful and that nit'urine was addictive and debated whether to make the research public; • that the industry decided to conceal the truth from the public; • that the industry hid their research from the courts by sending the data through their legal departments, their lawyers asserting that the results were immune to disclosure in litigation because they were the privileged product of the lawyer-client relationship; • that despite their knowledge to the contrary, the industry's public position was (and continues to be) that the link between smoking and ill health was not proven, that they were dedicated to determining whether there was such a link and revealing this to the public, and that nicotine was not addictive." ~ Banzhaf feels sure many more internal tobacco company documents will come to light as Castano and the state cases enter the discovery phase. He says that the Castano plaintiffs' attorneys already have paid $1 million ~solely for the purpose of buying a building to store the documents they expect to get." Banzhaf also senses that the pending suits may not produce all-or-re)thing results. "Modern product liability law increasingly recognizes that in many situations, both sides bear some responsibility," he says. "Efforts are made to apportion the blame in some reasonable way. So, the issue in the current suits is not, 'Should the plaintiffs get a free ride,' but rather, 'Should the defendants bear some responsibility for the enormous costs they impose on individuals, health plans, states, welfare departments and so on.' And you have to figure, considering all the 'crazy' product liability cases that plaintiffs have won lately, that some jury is finally going to say to tobacco, 'enough is enough,' and award damages." That day has yet to come -- and it likely will be long in arriving, if it ever does. Banzhaf confidently predicts that the pending litigation will extend well into the 21st century. *These cases," he says, "are going to make the O.J. Simpson trial look like a 100-yard dash." t In 1988, a jury in Newark, N.J.. awarded $400.000 to the family of a deceased smoker, Ro.~ Cipollone. The family claimed that cigarette manufacturers knew cigarettes were dangerous but deceived smokers through their advertisements. The award was overturned in 1990 b}' the U.S. Court of Appeals in Philadelphia. which held that the federal law requiring warning labels on cigarette packages pre-empted state liability claims. In 1992. the Supreme Court ruled, in Cipollor*e u. Liggett Group Inc., that Ihe federal labeling law does not protect tobacco companies against all personal-injury suits under state law. That part of the opinion was decided by a 7-2 vote. Then, a plurality of four justices concluded that, for the Cipollones, the act pre-empts the failure to warn and fraudulent misrepresentation claims but dots not pre-empt lawsuits based on intentional fraud, mbrepresentation or conspiracy. See The 1991-92 Supreme Courf Yearboo& Congres.sional Quarterly, 1993, pp. 20-23. *The companies named in the suit arc the American Tohacco Co.. Brown & Williamson Tobacco Corp.. R.J. Reynolds Tobacco Corp., Philip Morris Inc.. Lorillard Tobacco Co.. United States Tobacco Co., Liggett Group Inc. and The Tobacco Institute. ~For background on tort reform, see "The Jury. System." The CQ Researcher. Nov. 10. 1995. p. 1006. ~James S. Tndd. ctal.. "The Brown & Williamson Dt~cumems: Where Do We Go From Here?" TheJounml of the American Medl¢ol Assoc~aUon. July 19. 1995. p. 256. ation calls for tough measures. Defend- ing the proposed ban on cigarette vend- ing machines, the FDA noted that the 1994 surgeon general's report on youth smoking had found young people were able to buy cigarettes from the ma- chines 88 percent of the time. The agency justified banning mail- order cigarette sales on the ground that "current indt, stry practice only asks the consumer to provide a birth date or check [al box to verify, age.~ And it said cigarette brand-name spon- sorship of tennis tournaments, auto races and the like should end because such events "associate tobacco prod- ucts with excitement and glamour, and provide a way for tobacco brands to be advertised on television despite the broadcast advertising ban." -'~ A Republican Approach Proponents of curbs on cigarette marketing pitched to minors usually are assumed to be liberals. But in a July 17 open letter to House Speaker Newt Gingrich, R-Ga., Whelan and other members of a group called Concerned Republicans for Science and Public Health asserted that the issue troubles many conservatives as well. -'~ Smoking is ~a physically addictive, life-shortening habit taken up prima- rily by kids," the letter stated. "Sounds like a habit conservatives would be loathe to defend and against which they might willingly campaign. In- stead, anti-smoking efforts are domi- nated by well-meaning social engi- neers and safety alarmists whose ex- pansive agendas all but guarantee that many on the right gravitate to the opposite camp." What to do? According to the letter, the overriding need is "an anti-smok- ing agenda consistent with personal freedom, commercial free speech and minimal government ~ that is, a public health agenda Republicans can embrace." To this end. Gingrich was urged to dissociate himself from the ~ 1, 1995 1079 TI31241634
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AND TOBACCO tobacco industry, openly denounce tobacco ads that target young people, support vending machine bans "where underage access is not restricted" and encourage state and local action to bar cigarette sales to minors. Above all, the letter called on Gingrich to back efforts to make tobacco compa- nies play by the same liability rules as other industries. =The only way to do this, ironic as it may sound, is to remove the government warning label from ciga- rettes and let tobacco companies put on whatever warnings they choose -- or none at all." The purpose would be "to place the burden of complete warning and disclosure where it belongs m on the industry." "Elsewhere in American commerce," the letter noted, "manufacturers issue detailed, explicit and even hyperbolic warnings about the risks of their prod- ucts. They want to be sure no litigant can accuse them of deception. The tobacco industry, by contrast, not only downplays every potential risk. it even denies that nicotine is addictive." Removing the government warning labels "would force them into a choice: full. ongoing, detailed disclosure to consumers -- or the likelihood of huge legal payouts to the victims of ciga- rette-related disease who successfully sue the tobacco companies." Spotlight on Smoking As policy-makers discuss what to do about youth smoking, rival inter- est groups are placing paid messages in major newspapers across the country. Aseries of full-page ads by R.J. Reynolds Tobacco Co. stressed the pitfalls of over- regulation. The FDA proposal "will bal- loon the federal bureaucracy, which will gain unprecedented control over virtu- ally every aspect of the tobacco indus- to/.." said a full-page Reynolds ad in the .Sept. 26 Washington Post. A similar ad in the Oct. 5 Pact c'au- tioned that the government "should not replace parents and teachers when it comes to educating our children about smoking, ddnking and other important lifestyle decisions." Agreeing that "we must do something" to keep underage children from smoking, R.J. Reynolds declared that, "A proven solution is to teach young children how to resist peer pressure and to enforce the existing laws in 50 states denying children ac- cess to cigarettes." Newspaper ads l~laced by the Cam- paign for Tobacco-Free Kids, a coali- tion of more than 100 public health, education and religious groups, took aim at recent political activity by to- bacco companies. "During the first half of 1995, tobacco industry contri- butions to political parties skyrock- eted more than 400 percent," said a Nov. 13 coalition ad on the op-ed page of The New York Times, "To- bacco companies gave more than $1.6 million ($1.5 million to Republicans), becoming the GOP's largest donor by far." The reason, declared the ad, is that "Tobacco companies are desper- ately trying to buy opposition" to the FDA's proposed marketing curbs. Recent scientific studies and news reports also have trained the media spotlight on teen smoking. Two studies released at a mid-October news confer- ence in Washington. D.C.. concluded that cigarette advertising does indeed influence 14-to-17-year-old children to take up the tobacco habit. The historical survey by Pierce and Gilpin looked at four periods that coincided with "major marketing campaigns designed to stimu- late demand for cigarettes within one gender or the other." In each case. they concluded, the smoking rate rose within the targeted gender group ~ but not within the non-targeted group. A second study. also co-written by Pierce, sought to measure teenagers' susceptibility to smoking on the basis of answers to questions on cigarette advertising and exposure to friends and family mem- bers who smoked (see p. 1070). Philip Morris, the nation's largest to- bacco company, sought to blunt the teen smoking issue by announcing Aug. 8 that it had begun labeling its cigarette packs and cartons with the warning, "Under- age Sale Prohibited2 The company also said it would provide free training for retailers on how to request proof of age from customers and ascertain whether the information was correct. The Philip Morris initiative followed a 1994 policy announcement saying the company would punish stores that sold cigarettes to underage customers. This October, the Minnesota attorney general's office sent Philip Morris police records of 15 retailers caught selling tobacco to minors and asked it to make good on its pledge. The company de- clined to take immediate action. Philip Morris added, however, that it wnuld withhold certain monthly incentive payments from retailers that sell to teens after next year's contracts are written. Many parents doubtless were i~" startled by a recent study alleging that The Weekly Reader. a publication aimed at grade-school children, ran articles reflecting the tobacco industry's stance on smoking. Edith Balbach and Stanton Glamz. researchers at the Uni- versity of California-San Francisco. ported that 68 percent of Week/y Reader articles they studied toni:tined industry, views, while 38 percent car- ried a clear anti-smoking message. At the time the WeeklyReaderarticles appeared, between 1989 and 1994. the paper's owner was the largest share- holder in RJR Nabisco. the corporate parent of R.J. Reynolds. Of the smoking articles Baibach and Glantz examined in Scholastic News. a similar weekly. 32 pement echoed the industD' I:x~sition and 79 percent warned against cigarette health hazards. David Adler, a spokesman for K-III Communications. the current owner of The Weekly Reader. said Nov. I that the University of California study was "wrong" and "subjective." He added. "The Weekly Reader is probably more 1080 T!31241635
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Should the govemnera restrict the adv " promotio di.oqlm- tion and mark 'ng of cigarettes to teenagers? I~Y~SlDENT CLINION adutts ~e ~bl~ of ~g ~k o~ ~cisM~ a~ut whe~er tQ.$mok¢. Bgt'~e all ~ that children ~ es~cialV ~pt~le to the d~dly , temptation of to~c~o, and ~ skOt~l marketing .... When Joe Camel tells yo~g.child~n ~t sm~ng c~fl. when bill~Ms tell t,e~ ~t smoki~ ~1 lead to t~e romance, when Virginia Sli~ tell adolescents that cigarettes may ~ke them thin and glamrous, then our children n~.~r wisdom, our guidance and our experi- ence. We~ ~ir parent, and it is up to us to protect them. So today I am authorizing the Food and Drag Administ=- tMn to initiate a broad series of steps all designed to stop sales and marketing of cigareues and smokeiem tobacco to children. As a result, the following steps will ~ taken: First, young people will have to prove their age with an ID cam to buy cigarettes. Second, cigarette vending ma- chines which circumvent any ban on sales to kids will be prohibited. Third. schools and playgrounds will be free tobacco adve~ising on billboard, in their neigh~)rhoo6~. Fou~h, images such as Joe Camel will not appear on billboards or in a6~ in publications that reach substantial numbers of children and teens. FiSh, teens won't be targeted by any marketing gimmicks, =nging from single cigarette sales to T-shi~s. gym bags and sponsorship of ~po~ing events. And. finally, the tobacct~ indust~" must fund and implement an annual $150 million campaign aimed at stopping teens from smoking through educational Now, these are all common-se~e steps. They don't ban smoking: they don't bar adve~ising. We do nol. in other wor~, seek to address activities that seek to sell ciga~ttes only to adulLs. We are stepping in to protect thrme who need our help. ~lne=ble young people. And the evidence of increasing smoking in the last few years is plain and compelling. Now. nobody much likes government regulation. And I would prefer it if we could have done this in some other way. The only other way I can think of is if Congress were to write these restrictions imo law. They could do that. And if they do. this rule could become unnecessa~'. But it is wrong to believe that we can take a volunta~ approach to this problem. And absent congressional a~ion, and in the presence of a massive marketing and lobbying campaign by cigarette companies aimed at our children, dearly. I have no alternative but to do thing I can to bring this as~ult to a halt. Tm~ EcoNomsr ~he [Clinton ~~ ~l "~ded ~ ~late nicotine ~ an a~ ~d ~1 ~k (which it is). ~ ~gtmng from ~t ~ ~ woM~ among other things, require cite ad~~ on ~ar~s and mosa ~gazines m ~ in ~u~-~n~ b~ck and white. ~th no pkmms; ~n cite b=~ f~m s~n~dng ente~i~¢nt or spoaMg even~; and ~qui~ tobacco compa- nies to s~nd $150 million a y~r on anti-smokMg campai~s aimed at t~nag¢~. For pr~nt pu~s. leave reside, as many Eu~an coun~ have done. the co~k$~ ~e~ m~asures create with f~edom of s~ech. ~at apan, d~s th£~ new ~war" on teenage smoking make pmexi¢~l It is ceaainly tree that smoking is hazaMous to the healS. ~ is eating lo~s of fat. or riding motortTcles (which are 16 times deadlier ~an ¢~rs). A ii~ral ~eW no,ally lets ~ople take f~lish ~sks. prodded flxe fisk-takem pay ~e coscs and assume them knowingly. In the cram o~ smoking, they do. Vi~xtsi. an econo~st at ~efica's Duke Unive~i~', recently had the most comprehensive i~)k to ~te at who pays for ~efi~a's tobacco habit. He concludes, as othe~ have done. that smokem pay their own ~ay. ~at they co~ in medical bills, fires and so on, they more than repay in ~ions they do not live tt) collect and numing-home cam they never Tobacco taxes in America are now more than high enough to cover any residual costs of mcond-hand smoke. Far from ha~ing ~ieS"..~eri~an smoke~ hu~ only But surely the case is different with teenagers? Apparently not. Most people- smokers and non-smokers ~ overesti- mate the dangers of smoking by ~ factor uf two t~ Teenagers. it turns out. have an even morn ¢xa~erated view of smoking's ~rils than grown-ups do. Even among American 8-yeavol6~. 97 ~rcent know that smoking causes cancer and shoffens life, and the vast ma]oriff know it hard to stop. If t~nage~ smoke, that is not ~aus¢ the are ignorant. Perhaps their judgment a~ut stoking is poorer than &eir eiders'-- but even that is unclear: ML Visc~i fin~ that teenagers are as likely to act, or not a~, on their knowledge a~ut smoking as are adult. Requiring drag companies -- including cigarette makem -- to di~lge the har~l effe~ of their pr~ucm is a g~d thing. So is forbidding sales to mino~, who should have their parenm' pe~i~sMn m smoke. However. spending millions of scarce dollam to educate people who demonstra- bly do nm ne~ ~her educming is rather le~ sensible .... Im~ead of ~tMg ~g~g~ like ~er additive ~,. l~ ~fi=~ ~at ~r addi~ve ~gs I~e dgam~es a~ ak~l: puM~ize ~e fi~ mx ~ ~m a~ ~n ~l~ to ~. ~en 1995 1081 TI31241636
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AND TOBACCO Action on Smoking and Health, 2013 H St. N.W., Washington. D.C. 20006: (202) 659-4310. ASH distributes information about smoking hazards and the rights of non-smokers. Association of National Advertisers, 155 E. 44th St., New York, N.Y. 10017: (212) 697-5950. ANA. a coalition of national advertising groups, opposes the Food and Drug Administration's proposed tobacco advertising regulations on First Amendment grounds. Monitoring the Future Project, Survey Research Center, University of Michigan. Ann Arbor, Mich. 48106-1248: (313) 763-5043. The center has been studying smoking patterns among American teenagers since the mid- 1970s. The Tobacco Institute, 1875 Eye St. N.W.. Suite 800, Washington. D.C. 20006; (202) 457-4800. The institute provides information on the tobacco industry, but does not comment on current litigation. Conmtuedfn~mp. 1080 influential than any other entity in dis- couraging children from smoking .... It's absurd to think that The Weekly Reader is pro-smoking." -': The publishing giant Knight-Ridder Inc., whose 26 newspapers include the Miami Herald and Philadelphia Inquirer, recently announced it had issued guidelines allowing, but not requiring, its publications to reject cigarette ads that seem to target chil- dren and teenagers. The company said it adopted the policy in response to proposals submitted at its last share- holders' meeting by the Interfaith Center on Corporate Responsibility, a New York-based group that promotes "socially responsible" investment. Commenting on the move, Knight- Ridder President John Fontaine said: "On the one hand, [cigarettes] are legal prod- ucts. and lots of legal products are ad- vertised in newspapers that people don't like, including the content in personal classifieds. On the other hand. there's a growing concern about the health impli- cations of young people smoking." ~ Bhcks' Smoking Drops I n-depth research is just getting un- der way on a subject that fascinates all parties to the teen smoking debate -- why cigarette use among black young- stets has fallen so far below the rate for white youths. Whatever the reason turns out to be, "We want to bottle it, so we can sustain it for black teens and pass it along to white teens," said Michael Eriksen, director of the CDC's Office on Smoking and Health. -'~ The disproportionate drop in smok- ing among African-American youths is all the more striking in view of the volume of cigarette ads targeting black neighborhoods. According to the De- partment of Health and Human Ser- vices, "Billboards advertising tobacco products are placed in African-Ameri- can communities four to five times more often than in white c~mmunities." .~ Sherry L. Mills, a medical officer at the National Cancer Institute, con- ducted focus groups in five cities * in late 1994 and early this year in an effort to determine why black young- sters were tuning out cigarette ads. Each group consisted of about a dozen black 12-to-18-year-olds, including smokers and non-smokers. A key finding, says Mills, is that "there is a strong parental influence in black teenagers' decision not to smoke." Although the parents them- selves may be smokers, "they're tell- - Greemboro. N.C... "Kansas Cit,/. Kan.. Lo~ Angck~, Calif. New Orleans. La.. and Washington. D.C. ing their kids not to smoke. And for some reason we can't yet pinpoint, the kids are listening to that- even though it's counterintuitive to typical teenage behavior. The most common remark we heard was, 'My mother would kill me if she caught me smok- ing a cigarette.'~ Some commentators have speculated that many black teens don't have enough disposable income to buy ciga- rettes on a regular basis. But Mills says that's not the case. "They have money to spend, just like every other kid does. They're simply choosing not to spend it on cigarettes. They know that bad things will happen to you if you do." In addition, focus group partici- pants viewed smoking as "a white activity." They pointed out that white teens like to smoke and drink beer at parties, but black teens don't. "They'd rather dance and mingle," Mills says. Asked to speculate on why smok- ing is more prevalent among white than black teens, focus group mem- bers said they sensed that cigarettes are ~much more tolerated" in white homes. "They felt that white parents made cigarettes more accessible to their children, either through buying or sharing, and did not warn their kids not to smoke." Mills says. "They also said they didn't think any white kids would get in really big trouble if their parents found out that they smoked," Johnston points to another possible reason for smoking's unpopularity among black teens. ".M3 awful lot of black youngsters, especially boys. are involved with sports of some kind," he notes, "And needless to say, smoking and sports don't go together very well, So that could be a factor.~ The CDC has agreed to fund re- search on smoking by African-Ameri- can teens, so more definitive data could emerge before long. One goal of the research, Mills suggests, might be identifying ~what aspects of behav- ior in the community and the home 1082 TI31241637
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:! could be stressed" to reinforce black youths" aversion to smoking. Pierce suspects that the tobacco in- dustry is trying to reposition its products among African-Americans. "That's why we're starting to see an increase in smoking by black you*Mngsters," he says. "'The wdrst thing that could hap- pen to the companies would be to have one entire population group turning away from their product." • OUTLOOK New Worries Anti-smoking activists are heart- ened by the stories about smoking trends among black teens, but Whelan at the American Council on Science and Health cautions that they could be used to weaken the movement. Already, she notes, "There are edito- rials that say, "We don't need govern- ment intervention.' The editorials go on to argue, "Look at what happened in the black community. Teenage smoking fell without government regulation. So let's figure out a way.' You see? They're saying that this decline occurred despite the tobacco industry's $6 billion in ads and promotion, that it's a cultural thing, and that parents can handle the situa- tion by themselves. It's a very interest- ing rejoinder." In this connection, Pierce observes that the tobacco industry has long displayed agility in adjusting to sud- den changes in market conditions. Cigarette sales slumped after radio and television advertising was banned from the airwaves in 1971, but rebounded shortly afterward as industry market- ing outlays were shifted away from advertising and toward promotion. In Pierce's view, that scenario will be played out again if the FDA's pro- posed curbs on youth-oriented ciga- rette marketing take effect. He fore- sees a slowing in the rate of increase in teen smoking, or possibly even a decline, "until the industry can come up with another effective way to get at kids." He adds, "They're not volun- tarily going to leave kids alone." "We're going to have to revisit the youth smoking issue again in a few years-- no question about that," Pierce says. The FDA rules package represents "a piecemeal solution, a start," Pierce feels. "It's not a final answer." Experience suggests aggressive anti-smoking campaigns also can do just so much, Pierce adds. He cites Australia and Canada, where the top third or bottom third of cigarette packs bear a stark, black-and-white message, such as "Smoking Kills." An Australian opinion survey showed that most smokers approved of the no-nonsense warning. "It didn't make a lot of them stop smoking, though," Pierce says. The proposed FDA regulations may not offer a final solution, but in Banzhat% opinion, they are a worthy goal to pursue. Children would still manage to get their hands on ciga- rettes under the FDA regulations, he acknowledges. "But if we could knock the teen smoking rate down by 10 or 20 percent, that would be important: it would be very important." II Notes i The figures were compiled by the ongoing Monitoring the Future Project of the Univer- sity of Michigan's Survey Research Center. The center defines a smoker as a person who smoked one or more cigarettes a day during the previous 30 days. -" Quoted in a University of Michigan news release, July 17, 1995. "Ibid. ~ For background. ~ "Pr~'enting Teen Drag The OQ Rt~earchem July 28. 1995, pp. 657680. s Banzhaf also is a professor of public inter- est law at George Washington University. ~' For background, see "Regulating Tol~cco," "/be CQ Researcbe~. Sept. 30. 1994. pp. 8~1.-864. "Centers for Disease Control and Preven- tion, -Changes in the Cigarette Brand Pref- erences of Adolescent Smokers -- United States, 1989-1993." Morbidity and Mortality Weekly Report, Aug. 18. 1994, p. 579. " Nicola Evans. et al., "Influence of Tobacco Marketing and Exposure to Smokers on Adolescent Susceptibility. to Smoking," Jour- nal of tbe National Cancer lnstttute. Oct. 18, 1995, pp. 1538-1545. * Remarks at news conference in Washing- ton, D.C.. Oct. 17, 1995. 1°Evans. op. cit., p, 1540. tt Ibid.. p. 1545. n Opening remarks at a White House news conference, Aug. 10. 1995. Is The deadline for public comment on the FDA proposals is Jan. 2, 1996. ~ Quoted in The Washington Post, Aug. 16, 1995, p. A17. ,s Letter to the editor of TbeNew ~brker, May 16, 1994. I° Jordan Goodman, Tobacco in Histo~. : The Cultures of Dependence (1993), p. 100. ~ Ibid.. pp. 100-101. t~John P. Pierce and Elizabeth A. Gilpin, "A Historical Analysis of Tobacco Marketing and 'the Uptake of Smoking by Youth in the United States: 1890-1977," Health Psychol- oItv, November 1995, p. 5. t~U.S. Department of Health and Human Services, Preventing Tobacco Use Among }bung People: A Report of the Surgeon Gen- eral 1994, p. 166. ..0 1bid.. p. 167. .,t Quoted in a Univer.sity of Michigan news release. July 17. 1995. ..2 Ibid. '.~ U.S. Department of Health and Human Services, "Children and Tobacco: The Prob- lem" (Aug. 10. 1995. fact sheet). :°In the letter to Gingrich. they describe themselves as a group of independent Re- publican physicians and scientists. -'~ Pierce and Gilpin, op. cir.. p. 1. -" Baibach and Glantz" findings were pre- sented Oct. 31 at the American Public Health Association's annual meeting in San Diego. -" Quoted by Howard Kurtz in The Washing- ton Post, Nov. 2, 1995, p. C1. 2~ Quoted in 7"be Wall Street Journal, Nov. 14. 1995, p. BI. '~ Quoted in "H~-~ked tm Toiracx-~. The Teen Epi- demic," Con.s;unve,r/~0ortx Mamh 1995. p. 145. ~ U.S. Del:mtment of Health and Human Ser- ,.'ices, "Facts on Mrican-Americans and Smok- ing," undamd. December 1,1995 1083 T!31241638
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Biblio aphy Selected Sources Used Books Goodman, Jordan, Tobacco in History: The Cultures of Dependence, Routledge, 1993. Arguing that tobacco "is best understood in historical terms," Goodman contends that "The cigarette is the result of a complex process of cultural accretion of which changes in cultivation, production and marketing are an essential part. Any attempt to eradicate tobacco from our lives, however well-meant, will founder unless the com- plexity of its cultural significance is recognized." Articles Centers for Disease Control and Prevention, "Reasons for Tobacco Use and Symptoms of Nicotine With- drawal Among Adolescent and Young Adult Tobacco Users m United States, 1993," Morbidity and Mortal- ity Weekly Report, Oct. 21, 1994. This study states that, in 1992, "approximately two- thirds of adolescent smokers reported that they wanted to quit smoking, and 70 percent indicated that they would not have started smoking if they could choose again. Most adults probably could be prevented from becoming to- bacco users if they could be kept tobacco-free during adolescence." Evans, Nicola, et al., ~Influence of Tobacco Marketing and Exposure to Smokers on Adolescent Susceptibil- ity to Smoking,'Journal of the National Cancer In- stitute, Oct. 18, 1995. Evans and her co-authors assert, among other things. that "Tobacco marketing may be more effective in pro- moting the general product category than in promoting the particular brand of cigarettes." They came to that conclusion because, in their survey sample, "the pre- ferred brand of purchase was Marlboro. yet the cigarette advertisements most favored by adolescents were those for Camel." Glantz, Stanton A., et al., "Special Communications" (six related articles on internal documents from the Brown & Williamson Tobacco Corp.),Journal of the American Medical Association, July 19, 1995. This long special section of JAMA consists of articles by academic researchers analyzing the import of approxi- mately 4.000 pages of leaked documents from Brown & Williamson Tobacco Corp.: a response by the company: and an editorial in which the American Medical Associa- tion "reminds physicians, the public and politicians that the damning evidence against tobacco makes opposition to its use a pressing, nonpartisan public health issue." Pierce, John P., and Elizabeth A. Gilpin, "A Historical Analysis of Tobacco Marketing and the Uptake of Smok- ing by Youth in the United States: 1890-1977," Health Psychology, Vol. 14, No. 6, 1995. Pierce and Gilpin examine the impact of four separate cigarette ad campaigns -- two targeting males and two targeting females. They found that "marked increases in the rate of smoking intake in the particular gender group targeted by these campaigns were coincident with the beginning of each. Such an effect was not observed among the non-targeted gender." Zegart, Dan, "Breathing Fire on Tobacco," The Nation, Aug. 28-Sept. 4, 1995. Zegart, a freelance writer and reporter, traces the back- ground of Castano v. American Tobacco Co. et at, a potentially mammoth class-action suit against tobacco companies pending in New Orleans. "As two armies of lawyers gird for battle ... the issue of youth targeting is a mystery weapon that could decide the outcome," he writes. "The difference between a sinister ad campaign and making the youth charge stick in court is consider- able. But somewhere in the dark world of cigarette company memos, there just could be a folder of proof." Reports and Studies U.S. Department of Health and Human Services, Pre- venting Tobacco Use Among Young People: A Report of the Surgeon General, 1994. This 314-page report, issued during the surgeon generalship of Joycelyn Elders. surveys the history, epidemiology and health consequences of tobacco use by adolescents, as well as efforts of tobacco companies to promote their products and campaigns by anti-smoking groups to pre- vent tobacco use by the young. "The direct effects of tobacco use on the health of young people have been greatly underestimated." Elders states. U.S. Food and Drug Administration, Nicotine in Ciga- rettes and Smokeless Tobacco Products Is a Drug and These Products Are Nicotine Delivery Devices Under the Federal Food, Drug and Cosmetic Act, August 1995 (published in the Federal Register, Aug. 11, 1995). The FDA presents a detailed rationale for its claim of authority to regulate tobacco products. In sum. the lengthy document argues, -the evidence before the agency dem- onstrates that cigarettes and smokeless tobacco products are intended to affect the structure and function of the body. Accordingly, the record before the agency demon- strates that cigarettes and smokeless tobacco products are drug delivery systems whose purpose is to deliver nico- tine. a drug, and, hence, are devices under the [Federal Food, Drug and Cosmetic] Act." 1084 T!31241639
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The Step Additional information from UMI's Newspaper & Periodical Abstracts database Clinton Administration/FDA Proposals Aimed at Teen Smoking ~The attack on teen-age smoking," The New York Times, Aug. 11, 1995, p. A28. An editorial praises President Clinton for backing a regulatory campaign to curb the sale and promotion of cigarettes to young people. Ctmons, Marlene, ~FDA sees carding as key deterrent to teen smoking," Los Angeles Times, Aug. 11, 1995, p. A27. If the new restrictions on cigarettes work as the govern- ment intends, a teenager trying to buy a pack of cigarettes would be asked for identification, making cigarettes less accessible and desirable and possibly providing the land- mark health measure that President Clinton has pro- claimed. Clmons, Marlene, "Legal battle looms over rules to curb teen smoking," Los Angeles Times, Aug. 12, 1995, p. A24. The impending legal battle between the FDA and the tobacco industry over the possible regulation of cigarettes is examined. Freedland, Jonathan, ~Clinton targets teen smoking," Guardian, Aug. 11, 1995, p. 10. On Aug. 10, 1995. President Clinton unveiled a list of measures aimed at reducing teenage smoking. Hilts, Philip J., "FDA head calls smoking a pediatric disease," The New York Times, March 9, 1995, p. A22. FDA Commissioner David A. Kessler said on March 8, 1995, that smoking was fundamentally a pediatric disease because most addiction to tobacco begins among teenag- ers. Kessler outlined a program to prevent young people from becoming addicted to nicotine that would include restricting access to tobacco products and possibly ban- ning certain kinds of advertising. Manning, Anita, ~Industry sues over teen smoking effort," USA Today, Aug. 11, 1995, p. AI. President Clinton's authorizing the FDA to regulate nicotine as a drug in order to curb teen smoking was challenged quickly with a lawsuit by tobacco companies and advertisers who are questioning the legality of the move. Morehouse, Macon, "Some say restrictions won't make dent in teen smoking,~ Atlanta Journal Constitution, Aug. 13, 1995, p. H6. Georgia has one of the tougher state laws aimed at stopping teenagers younger than 18 from lighting up. but as is the case across the U.S., enforcement is lax. This troubling trend is explored. Mowbray, Rebecca, "Businesses saw anti-smoking handwriting on the wall," Los Angeles Times, Aug. 11, 1995, p. D1. Many businesses said on Aug. 10, 1995, that they have already made sure that they are not hooked on tobacco revenue, after President Clinton expressed his support for plans to curb and regulate teenage smoking. Cigarette vending machines are one casualty of anti-smoking cam- paigns. Savage, David G., "Ex-tobacco lobbyist joins Clinton in fight on smoking," Los Angeles Times, Aug. 13, t995, p. A21. The White House stepped up its campaign against tobacco on Aug. 12, 1995, as a former tobacco industry lobbyist who is dying of throat cancer, Victor Crawford, joined President Clinton to urge young people to stay away from cigarettes. Schwartz, John, ~Top cancer scientists join crusade on teen smoking,~ The Washington Post, Aug. 16, 1995, p. A17. Just days after being sworn in as director of the National Cancer Institute, Richard D. Klausner and his boss, NIH Director Harold E. Varmus, ioined the Clinton administration's campaign against teenage smoking. They signed a letter urging Clinton to take on the powerful tobacco industry. ~Teen smoking: President right to take message to tobacco country," Detroit News & Free Press, Aug. 13, 1995, p. F2. A Detroit Free Press editorial opines that President Clinton is correct to bring his plan to stop teen smoking to tobacco country, Clinton visited North Carolina to launch a new phase of the program. ~Teen smoking," The Wall Street ~'ourna~ Aug. 25, 1995, p. A8. An editorial examines President Clinton's campaign to reduce teen smoking, saying that although the president's new efforts will likely score political points, his specific proposals would be further government-imposed nui- sances, whose chief direct effect will be to make million- aires of a few more lawyers. Decrease in Smoking Among Black Teens Hilts, Philip J., ~Black teen-agers are turning away from smoking, but whites puff on," The New York Times, April 19, 1995, p. C10. According to a study being reported on April 19. 1995. Detetat~ 1,1995 1085 T!31241640
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mENS AND TOBACCO in the Journal of the National Cancer Institute. African- American teenagers have largely eliminated smoking from their lives, while white teenagers are still taking up the habit at high rates. Researchers say the difference is due to a change in attitude and social norms. By 1993, only 4.4 percent of black teenagers took up regular smoking, compared with 22.9 percent for whites. Husted, Amanda, "Study.- Black teens are cautious about smoking," Atlanta Constitution, April 25, 1995, p. BS. Black teenagers are a lot more careful about taking care of their health than white teens when it comes to the use of tobacco products, a report in theJournaloftbeNational Cancer Institute says. "New study reveals black teen-agers have kicked the smoking habit, while whites remain hooked,"Jet, May 8, 1995, p. 23. A recent survey indicates that black teens have nearly eliminated smoking from their behavior, while white teens remain hooked on cigarettes. Figures from 1993 show that only 4.4 percent of black teens began smoking that year, as compared with 22.9 percent of white teens who began smoking regularly. Impact of Advertising~Marketing on Teens Kong, Dolores, ~Studies link tobacco marketing to smoking among the young," Boston Globe, Oct. 18, 1995, p. 10. Cigarette advertising has more influence on whether adolescents start smoking than does having friends or family members who smoke, according to a new study. Levy, Doug, "Teen smoking rises; Propped up by ads," USA Today, July 20, 1995, p. A1. A University of Michigan study found that smoking among eighth-graders iumped 30 percent from 1991 to 1994. The researchers attribute the increase in part to advertising and lower prices. Other survey results are related. Zielinsld, Graeme, "Smoking teens deride ads' power," Chicago Tribune, July 21, 1995, p. C2. Most Chicago teens said the idea to smoke did not come from tobacco industry advertising, it was more the lure of friends who smoke and the fact that they believe it is "cool." International Issues Clayton, Mark, "Canada steps up anti-smoking mea- sures," Chrtsttan Science Monitor, Aug. 17, 1995, p. 7. The growth in smoking among Canadian teenagers is discussed. The percentage of teens who smoke jumped from 23 percent in 1991 to 27 percent in 1995. The restrictions placed on cigarettes by the Canadian govern- ment are noted. De Vries, Hein, "Socto-economic differences in smok- ing: Dutch adolescents' beliefs and behaviour," Social Science & Medicine, August 1995, pp. 419-424. Smoking is more frequent among those who have a low rather than a high socio-economic status. The present study confirms that this is also true for Dutch adolescents. Symonds, William C., "Warning: Cigarette bans do not curb teen smoking," Business Week (Industrial/Tech- nology Edition), Aug. 28, 1995, p. 35. The effectiveness of a ban on cigarette smoking can be evaluated from the example of Canada's anti-smoking campaign. Canada did have a decline in teenage smoking, but it appears to have more to do with its stiff cigarette taxes than the effects of the advertising ban itself. Wasson, Nicola, "Where smoking is still seemly," USA Today, Sept. 5, 1995, p. A6. At a time when the White House is targeting teen smoking and Americans have all but ostracized smokers to the sidewalk, more than one-third of Japan's adults smoke, including 60 percent of men and 15 percent of women. Percentages of adult male and female Japanese smokers are compared for 1970, 1990 and 1994, and the percentage of Japanese men and women who smoked in 1992 is compared with percentages for both sexes in France, Germany the ILK. and the U.S. Smokeless Tobacco "Dipping into nicotine content in snuff," Science News, May 15, I995, p. 9. Two recent studies suggest that companies manipulate nicotine delivery in moist snuff, the smokeless tobacco that's tucked between the cheek and gum. A wide range of pH values and nicotine amounts were found in moist snuff. Husted, Amanda, "Smokeless tobacco use increasing among teenagers, CDC study says,~ Atlanta Constitu- tion, April 16, 1993, p. F4. According to the latest report on smokeless tobacco from the CDC, use of smokeless tobacco among teens is increas- ing while holding steady among adults. Squires, Sally, "Smokeless tobacco use still alluring to teens," The Washington Post, April 6, 1993, W16. The growing use of smokeless tobacco, such as chewing tobacco and snuff, among children and teenagers is dis- cussed. An epidemic of oral cancer deaths has been predicted by researchers in the next couple of decades unless steps are taken to halt the use of smokeless tobacco by youths. Teen Smoking Carman, Diane, "Parents have best shot at discourag- ing teen smoking," Denver Post, Aug. 19, 1995, p. El. Carman. noting steps President Clinton and Denver 1086 TI31241641
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Mayor Wellington Webb have outlined to stop teenagers from smoking cigarettes, says parents probably have the best chance of keeping teens from taking up the habit. "Denver joins fight against epidemic of teenage smok- ing," Dentmr Post, Aug. 21, 1995, p. BT. An editorial discusses Denver Mayor Wellington Webb's proposals to help reduce the epidemic of teenage smoking in summer 1995. Guttmann, Monika, "Why teens refuse to give up smoking," U.S. News & World Report, Aug. 7, 1995, p. 7. Peer pressure is one of the primary reasons why teenag- ers refuse to give up smoking, even though many know that smoking is detrimental to their health. Organized efforts to reduce teen smoking and reasons why they will prove to be largely ineffective are discussed. Hendrick, Bill, "Smoking appeals to world-weary teens, some say," Atlanta Constitution, Aug. 23, 1995, p. E3. Hendrick says that, according to psychologists, a key reason more teenagers are smoking is a sense of hopeless- ness about the future; a feeling that there's not much of a future to look forward to. Kittredge, Clare, "States try to snuff out teen smok- ing," Boston Globe, Oct. 1, 1995, p. 81. Maine and New Hampshire have come out with tough laws trying to prevent teenagers from smoking. In New Hampshire. anyone age 12 to 17 caught buying, smoking or possessing cigarettes faces a court summons, tip to a $100 fine, community service and anti-smoking classes. Price, Stephanic, ~Crystal Lake is out to snuff teen smoking," Chicago Tribune, Sept. 21, 1995, p. MCI. The Crystal Lake. Ill.. City Council passed a tough smoking ordinance that requires retailers to obtain a $50 tobacco license if they want to sell cigarettes, and it also requires manual or electronic locks on cigarette vending machines. Rusche, Sue, "Congress turns its back on teen smok- ing, drinking," USA Today, Aug. 30, 1995, p. A13. Rusche says that just when teen-age drinking and drug use are rising again, the House is dismantling the infra- structure that reduced adolescent drug use by two-thirds between 1979 and 1992. Teen Smoking Rates Carey, Anne R. and Web Bryant, "USA Snapshots: More white teens smoking," USA Today, July 17, 1995, p. D1. According to the American Lung Association, white males and females in grades 9-12 report frequent cigarette use (1-20 or more in 30 days), 15.0 percent and 15.8 percent respectively, while 8.0 percent of Hispanic males and 5.7% of Hispanic females smoke frequently and 4.5 percent of black males and 1.9 percent of black females smoke frequently. Hwang, Suein L., "Teenage smoking on rise, particu- larly among the youngest, U.S. study finds," The Wall Street Journa~ July 20, 1995, p. BT. Cigarette smoking among high school students is on the rise, and the younger the smokers, the more dramatic the increase, according to a major new survey funded by the National Institute of Drug Abuse. The report, an annual survey of drug use among U.S. high school students by the University of Michigan's Survey Research Center, found that the number of eighth-graders who said they lit up in the previous month soared 30 percent in a three-year period, from 14.3 percent in 1991 to 18.6 percent in 1994. Roan, Shari, ~Jump in teen smoking sparks furor," Los Angeles Times, Oct. 4, 1995, p. El. Six years after California launched a youth anti-smoking campaign, a new analysis shows that smoking rates among teenagers bulged after holding steady for three years straight. Among California children 12 to 17, 10.9 percent reported smoking recently. Struman, Maryann, "Smoking rates rise, especially among young teens," Detroit News & Free Press, July 2O, 1995, p. DS. According to a study released by the University of Michigan, more children and teen-agers across the U.S. are smoking. The largest increase was among 13- and 14-year- olds, which rose 30 percent between I991 and 1994. Women and Smoking "CDC: Women who started smoking young can't give it up," American Medical News, March 13, 1995, p. 9. A CDC study indicates that three-quarters of women who take tip smoking as teenagers will find it too difficult to quit later. Only 2.5 percent of all smokers quit each year. Dreher, Nancy, "Women and smoking," Current Health, April 1995, pp. 16-19. Women who smoke put themselves at a far greater risk for developing cancer, heart disease and a life of breathing difficulties than those who do not smoke, lteahh risks that affect women who smoke are detailed. Lerner, Sharon, "If we've come such a long way, why are we still smoklng?~ Ms., May 1995, pp. 22-27. Although overwhelming evidence shows that smoking causes disease, the number of female smokers, especially the young, continues to increase. The reasons that many women do smoke are examined. ~ I, 1995 TI31241642
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