Growing Up Tobacco Free Preventing Nicotine Addiction in Children and Youths (1994) / Chapter Skim
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1 TOWARD A YOUTH-CENTERED PREVENTION POLICY
1 TOWARD A YOUTH-CENTERED PREVENTION POLICY
Pages 3-26
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From page 3... ...
(This assumes that individuals who die from smoking-related causes would have experienced the life expectancy of the total population that is, smokers and nonsmokers combined had they not died prematurely.) For the population at large, this premature mortality translates into 6 million years of potential life lost each year.5 It is difficult, of course, to calculate a dollar value for the human costs of *
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4 CROWING UP TOBACCO FREE Ciyarenes kill more Americans than AIDS, ales murders Cigarette Smoking 418,690 ..... him, car aeeidents, :~.;'ides, llrugs, Combined.
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Most smokers begin smoking during childhood and adolescence, and nicotine addiction begins during the first few years of tobacco use. Moreover, decades of experience in tracking tobacco use show that if people do not begin to use tobacco as youngsters, they are highly unlikely to initiate use as adults.
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On the other hand, most children and youths who initiate regular tobacco use become addicted and their addiction persists for many years thereafter, perhaps through out their lives. This is why a youth-centered prevention policy is an essential part of any coherent strategy for countering tobacco-related disease and death.
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. In fact, among men alive today, more are former smokers than current smokers.~° Despite these impressive successes, the nation's progress toward eliminating tobacco-related disease is in jeopardy.
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It has been estimated that children and youths consume 26 million containers of smokeless tobacco annually.~7 The prevalence of smoking by youths has remained basically unchanged since 1980. Among high school seniors, the prevalence of regular smokers (i.e., those who have smoked in the past 30 days)
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The Emerging Public Health Consensus There seems to be general agreement among public health officials that
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JO ~ROWI~d UP TOD^~(O fR Smoking rates Are ~bovllbe same 10P hays And gIPIs to ape Mob schooIsenbrs.
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The justification for such a change does not depend on proving that makers and sellers of tobacco products intend to induce nicotine addiction among the nation's young people; it is enough that their promotional activities make tobacco use seem attractive and have a natural tendency to trigger a chain of events that has disastrous public health consequences in the long run. In sum, two trends have raised widespread concern among public health officials regarding the present status of tobacco control efforts.
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From page 12... ...
Hundreds of localities have enacted local ordinances banning vending machines, establishing smoke-free environments in public places, and otherwise promoting a tobacco-free norm.28 Unfortunately, strong grassroots support for tobacco control policies at the local level has too often been neutralized through powerful lobbying by the tobacco industry at the state level, resulting in weak state legislation that preempts more restrictive local measures. Legislative initiatives at local and state levels relating to advertising and promotion have also been stymied by a preemptive provision of federal law that precludes "any requirement or prohibition based on smoking and health." As discussed below, this preemption must be repealed in order to enable state and local governments to implement youth-centered tobacco control initiatives and thereby carry out the public will.
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From page 13... ...
Yet, as shown in chapter 2, a significant proportion of adult smokers begin using tobacco before becoming teenagers. Data from the 1990 Youth Risk Behavior Survey indicate that 56% of youths have tried smoking and 9% have become regular smokers by age 13.32 Some researchers have suggested that adequately informed adolescents (over age 13)
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Of those who smoked occasionally as seniors, only 58% had quit, but 37% had actually increased their cigarette consumption.40 If a youth decides to begin smoking at the age of 12 or 13, the deficit in his or her ability to appreciate the long-term risks of doing so is even more pronounced, and more disturbing, than it is at 16 or 17.4i Indeed, it is clear that the grip of nicotine addiction is most powerful and most enduring for youths who
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THE ELEMENTS OF A YOUTH-CENTERED TOBACCO CONTROL POLICY The U.S. Public Health Service has articulated its public health goals in Healthy People 2000, the result of a systematic planning process.
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During the course of its study, the Committee reviewed a wide range of activities federal efforts, state government programs, the actions of advocacy and health professional organizations, and policies of several foreign nations where tobacco control has been successfully pursued. Subsequent chapters deal with research and policy questions surrounding the addictive process, setting social norms, preventive and cessation interventions, advertising and promotion, pricing and taxation, diminishing youth access, and regulating tobacco products.
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This recommendation is discussed in chapter 4. :Congress should increase the capacity of state and local governments - and coalitions of interested organizations to pursue youth-centered ~ tobacco control policies.
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The Committee urges the federal government to broaden these initiatives with technical assistance, grants, and cooperative agreements to enable all interested states, local governments, and community coalitions to undertake youth-centered tobacco control policies. Actions Required To Sustain Progress in the Long Term The recommendations for immediate action will have a stronger impact if they are viewed as first steps in a long-term strategy for preventing nicotine dependence in children and youths and thereby reducing the adverse health consequences of tobacco use.
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Finally, some of the data most useful to the Committee came from studies of tobacco control policy, such as epidemiologic studies and risk-factor analyses that monitor the effects of policy change. For example, decisions about which policies are most
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From page 23... ...
On the other hand, successful tobacco control initiatives in the society as a wholesuch as the widespread adoption of tobacco-free policies establishing a normative climate unfavorable to smoking play an important role in preventing nicotine addiction among youths. In both respects, a successful youth-centered prevention policy is the most expeditious way to reduce tobacco-related disease.
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From page 24... ...
Major Local Tobacco Control Ordinances in the United States. Monograph 3.
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From page 25... ...
Division of Adolescent and School Health. Youth Risk Behavior Survey, unpublished data, 1994.
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