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It Takes a Village
The portion of teens that smoked cigarettes dropped to 28% in 2001 according to a report from the Centers for Disease Control and Prevention. That was down from 36% in 1997 as measured by the same survey, the Youth Risk Behavior Survey (YRBS). It's a triumph for many people across the nation who worked tirelessly to reverse the climb in teen smoking rates during the 1990s.
An equal accomplishment may be the discovery of what works to influence teens' famously erratic motivation and behavior. Success has come in communities with a comprehensive program to fight tobacco use by teens. The best school health classes won't have much effect on the students who already smoke, unless those teens are also offered professional help to quit.
Now the bad news: while the teen smoking rate is down to 28%, that means one in four teenagers still smoke. Public health leaders and parents are not ready to abandon a quarter of today's young people to the damaging effects of tobacco. "Now is not the time to rest upon our laurels," said Rosemarie Henson, M.P.H, M.S.W., director of the CDC's smoking and health program.
Nearly all first use of tobacco occurs before high school graduation. So if adolescents don’t start smoking by age 18, odds are they never will. For those who do experiment with cigarettes, new research shows teens can get hooked on nicotine more quickly than adults by extremely low levels of tobacco.
High Prices, Media Campaigns, School Programs Work
The CDC report attributed the drop in cigarette use to three things:
- A 70% increase in the retail price of cigarettes between December 1997 and May 2001
- Increases in school-based efforts to prevent tobacco use
- Increases in youth exposure to both state and national mass media campaigns.
"When the tobacco companies lost the lawsuit that made them pay for the disease tobacco has caused, they passed the costs of their legal problems on to smokers, raising the cost of cigarettes out of the reach of many young people," said Ron Todd, director of tobacco control for the American Cancer Society (ACS).
A 10% Tax Hike Equals 10% Fewer Teens Who Smoke
 Some states have boosted the cost of a pack of cigarettes further by raising taxes—probably the only popular tax increase anywhere, anytime in history. In Washington state voters overwhelmingly approved a 60-cent tax increase for a pack of cigarettes along with increases for other tobacco products, too. Revenue will go to tobacco prevention programs and health care for low-income people.
Price may be the most effective way to prevent teens from becoming daily smokers. A joint study from the University of Illinois at Chicago and the University of Michigan Institute for Social Research matched price hikes with teen smoking rates over six years. They found that a 10% price increase would decrease the number of children who started to smoke between 3% and 10%, depending on their stage of smoking, such as experimentation, beginning daily smoking, or relatively heavy daily smoking.
"More states that haven't (raised taxes) should do so. This will stop tax-skirting smuggling of cigarettes from low-tax to high-tax states and discourage youth smoking," Todd said.
One analysis by the activist group Campaign for Tobacco-Free Kids estimated that if cigarette prices were raised 10% per pack across the nation, it could save more than a million teens from becoming regular smokers.
Angry Teens, Executives in Bikinis
The most memorable anti-tobacco media campaign for teens using tobacco has been "truth" from the Florida Tobacco Pilot Program. Beginning in 1999, edgy TV ads showed angry young men speaking out against an industry that targets them for lifelong addiction to tobacco. Billboards ridiculed the tobacco companies' use of attractive, healthy models to advertise cigarettes by presenting their own models: men who looked like tobacco executives dressed in bikinis--a modern twist on the wolf in sheep's clothing parable. In a short time, nine out of ten Florida teens could recognize the "Truth" logo, an advertising coup matched only by giant companies like Coca Cola and Nike.
Florida's media onslaught was the most visible part of a comprehensive tobacco control program, which helped prove that an all-encompassing approach was needed to reduce teen smoking. It included in-school and after-school education at every grade level, programs to help teens quit smoking, enforcing the laws against shopkeepers selling tobacco to teens, and much more.
After four years, smoking rates among Florida middle school students dropped by 47%, and there was a 30% decline among high school students.
"Here's my cigarettes. I'm done." – Nebraska High School Student
Teen voices in the media and in person have been pivotal in capturing the attention of their peers and changing attitudes. The students running an anti-tobacco program at Plattsmouth High School in Nebraska felt scare tactics would work in their school. "Kids don't really want to think about the damaging effects of tobacco," explained tobacco team member Alex Williams.
They found a teen survivor of oral cancer who was willing to speak about smokeless tobacco and his illness. He started chewing at age 12 and by 17 had lost parts of his face to cancer. Williams says several students (and some teachers) turned in their cigarettes immediately after the program.
Student comments showed increased disdain for tobacco and considerable shock. "How can this little bit of chew you put in your mouth destroy half of your face?" said one boy. A year after the student-run "Do You Know That Tobacco is a Drug?" program, smoking rates had dropped by 11% at Plattsmouth High.
Success at the Community and State Level
So, when "villages" like the state of Florida pull together to protect children from stumbling into lifelong tobacco addiction, this comprehensive approach works. It is now clear how to stop teens from smoking.
ACS tobacco control director Todd explained, "If we continue to do these things that clearly work, such as taxing cigarettes substantially, and if more states use the money from the settlement wisely, and if caring members of the public continue their successful efforts, we might have a real chance to sustain this very important, life-saving downward trend in youth smoking."
The reward is nothing less than saving lives-- a lot of them-- and preventing considerable suffering.
Programs to Reduce Teen Tobacco Use
ACS Comprehensive Plan for Community Control of Tobacco
ACS School Health Initiatives
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