Tobacco use by teenagers fell dramatically between 2000 and 2002, but a range of anti-smoking efforts did little to deter middle school students from taking up the habit, according to data released yesterday by the federal government.
The proportion of high school students using tobacco dropped from 34.5 percent to 28.4 percent in a two-year period marked by higher tobacco taxes, new anti-smoking regulations and an aggressive media campaign aimed at discouraging young people from smoking, the Centers for Disease Control and Prevention found.
Although the researchers found a slight dip in smoking by younger children -- from 15 percent in 2000 to 13 percent in 2002 -- they said the decline was not statistically significant and raises concern that new strategies are needed to reach the nation's youngest smokers.
"The decline for cigarette smoking is pretty dramatic and very good news," said Corinne Husten, medical officer in the CDC's Office on Smoking and Health.
She and other experts said they cannot be certain why there was not a sharper decline in the 7-12 age group, but they speculated that few middle-schoolers pay for their own smokes and so are not as influenced by price increases as teenagers. A pack of cigarettes in the United States today costs between $3 and $8, depending on state taxes.
"Middle-schoolers don't have the chutzpah to go into a store and buy cigarettes," said Cheryl Healton, president of the American Legacy Foundation, an advocacy group that conducted the study with the CDC. Healton also suggested that portrayals of smoking in PG-rated movies may factor in the lure of tobacco for youngsters.
Youth smoking in the United States was rising until 1996-97, shortly before the tobacco companies signed a landmark 1998 legal settlement with 46 state attorneys general to pay $246 billion over 25 years for prevention programs. States have been using the funds for a variety of efforts, some aimed directly at smoking, others dedicated to broader health initiatives.
The study of 26,000 youths at 246 schools found no gender difference in smoking rates. White high school students were more likely to smoke than minorities, the survey found. Cigarettes continue to be the top tobacco product among young people. The survey was slightly limited, the authors acknowledged, because it did not include young people who are not in school.
Healton, whose foundation was formed as a result of the settlement, said the steady decline in tobacco use among youngsters over the past five years shows that anti-smoking efforts are working. However, she and others warn that state budget cuts could jeopardize that progress.
"The tragedy, in a way, is we do know what to do," Husten said. "Because of problems in the states with deficits, a lot of programs we know work are being cut just as we're starting to make some progress. It raises the specter these gains could be lost."
This year, states have reduced their anti-smoking budgets by $86.2 million, according to the advocacy group Campaign for Tobacco-Free Kids. Florida, for example, cut its widely acclaimed program from $38 million in this fiscal year to $1 million next year.
Locally, the District of Columbia spends virtually no money on tobacco-prevention programs, while Maryland and Virginia have slashed anti-smoking budgets to $14.8 million and $17.4 million, respectively. Overall, states are expected to collect $19.5 billion in tobacco taxes this year.
"States that have invested in tobacco prevention and control are reaping the benefits in healthier citizens and prolonged lives," said John R. Seffrin, chief executive officer of the American Cancer Society. "Comprehensive tobacco control programs work, but only if they receive funding."
Based on Federal Trade Commission data, the Campaign for Tobacco-Free Kids calculated that tobacco companies spend $20 on marketing for every $1 that states spend on prevention.
Tobacco use is the leading cause of preventable death in the United States, according to CDC, and accounts for $75 billion in direct medical expenses. Each day in 2001, 4,400 youngsters tried their first cigarette and about 2,000 began to smoke daily.
The agency projects that at today's rates, one-third of youngsters now smoking will die of a tobacco-related illness.
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Last updated: 11/21/2003 - 05:49 PM