Surgeon General's Report: Preventing Tobacco Use Among Youth and Young Adults

Mar 8, 2012, 2:58 PM, Posted by NewPublicHealth

file Danny McGoldrick, Campaign for Tobacco-Free Kids

A new report, Preventing Tobacco Use Among Youth and Young Adults, released this morning, is the 31st report from the Office of the Surgeon General focused on tobacco use in the U.S. NewPublichHealth talked about the new report with Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids.

>>NewPublicHealth was on the ground as the report was released. Read more on the new Surgeon General's report on youth tobacco use.

NewPublicHealth: What does the Surgeon General’s report tell us about progress in the fight to reduce youth smoking?

Danny McGoldrick: Well, unfortunately, it tells us that we’re not making nearly the progress that we need to. While smoking rates declined dramatically between 1997 and 2003—by almost 40 percent—between 2003 and 2009 they declined by just over 10 percent, and we still have almost 4,000 kids trying their first cigarette every day. So while we’ve made some progress, we’re not making nearly as much as we need to.

NPH: What is the report’s conclusions regarding the impact of tobacco marketing?

Danny McGoldrick: The report reaches the strongest conclusions ever that tobacco marketing and promotion is causally related to the uptake of smoking among kids and progression to regular smoking, and half of those smokers who smoke for their lifetimes will die early as a result of it. So, we need to try to prevent the tobacco companies from doing that.

The companies have sued over the FDA bill, which puts some restrictions on their marketing. They’ve sued over the warning labels, which will help educate the public about the dangers of tobacco use and encourage smokers to try to quit. So, they’re doing all the things they can to get around any restrictions that are put on them. But there are things the science is very clear about that we can do on the other side of the equation to try to prevent kids from starting to smoke and help adults quit that, and that includes increasing tobacco taxes. We know price is one of the most effective ways to reduce smoking, particularly among our kids. Tobacco prevention and cessation programs are evidence-based solutions to the problem, and despite the evidence states have cut 36 percent from their tobacco prevention and cessation programs in the last four years.

We know what to do, we’re just not doing enough of it to prevent tobacco use while the companies know what to do to cause it and they continue to do it all to the tune of over $10 billion a year in marketing and promotion.

For example, the tobacco companies pay billions of dollars to convenience stores to make their products accessible, affordable and attractive, and the science is clear that this has an impact. One of the provisions of the FDA law that the companies have challenged is to make all that in-store marketing black and white text only. So you get rid of all the colorful imagery that makes tobacco use seem so normal to a kid from the first time they can walk into a store. We know it’s at kid’s eye level and it’s just ubiquitous in virtually every retail outlet in the country, and so we’re obviously hopeful that the FDA law gets upheld by the courts so that we can limit the kind of image advertising that makes tobacco use seem so attractive to our young people.

NPH: What should policymakers do in response to this report?

Danny McGoldrick: The policymakers need to put in place those solutions that the science and this report conclude once again work to reduce tobacco use. At the state level, we’d like to talk about the state trifecta. The report concludes that price is one of the most effective things that we can do to reduce smoking, so our policymakers need to increase tobacco taxes. They need to fund these tobacco prevention and cessation programs, which again the report concludes are effective in reducing smoking among both kids and adults, and we need to pass our smoke-free laws that not only protect everybody’s right to breathe clean air free from the 7,000 chemicals in secondhand tobacco smoke, but also create an environment where smokers are more likely to try to quit and succeed in doing so.

NPH: What else is happening in the field to as far as momentum in curbing tobacco use?

Danny McGoldrick: What we’re seeing is some states that have passed strong smoke-free laws and have high tobacco taxes are looking to affect the retail environment where the tobacco companies now spend over 80 percent of their marketing dollars. Those dollars are spent in the retail environment where they know two-thirds of our kids visit at least once a week and they’re impacted by all this in-store marketing. We have some states and localities going after some innovative policies to restrict some of the discounting that’s going on and to impact the placement of tobacco products. There are some policies to get some of these flavored tobacco products that aren’t yet required to be behind the counter, like flavored cigars and flavored smokeless products that can be the entryway into tobacco use, moved behind the counter. Many of our states and local communities are laboratories for new and innovative policies that we can build an evidence base for, to add to those things that we have such great science for already.

NPH: If a state was to allocate an additional amount of money, what could have the most dramatic effect on tobacco use?

Danny McGoldrick: The CDC issues not only budget guidelines for what every state should be spending on these comprehensive programs but also line items on the evidence-based approaches that states should take. And, basically we talk about three things. We talk about mass media campaigns, and of course now the social media and all the other ways to get the word out, to educate people about the dangers of tobacco use, but also change the mix of messages that they’re getting to balance that $10 billion that the tobacco companies are spending to promote and advertise their products. So, your media campaigns are very important. The real heart of these state programs are the community-based programs, and this is getting resources into communities around the state and providing them with the kind of training and technical assistance to get that message out in a way that affects the most affected members of their community. And then finally, we need help for smokers who want to quit, which includes making sure that everybody has access to the science-based interventions that we know improve quit rates; counseling through the quit lines or other forms of counseling and also nicotine replacement therapies and other medications that we know help smokers quit and help them succeed.

This commentary originally appeared on the RWJF New Public Health blog.