As spending stalls, so does decline in teen smoking

Shortly after their historic settlement with the tobacco industry, Florida and other states began investing part of their proceeds in an edgy ad campaign aimed at teenagers.

The message was blunt and direct: Cigarette makers have a long history of manipulating people just like you and luring you into a costly and ultimately deadly addiction. Don't fall for it.

The campaign, soon adapted for national use, pitted the typical teenager's rebellious nature against one of the very things that had come to symbolize that rebellion - cigarette smoking.

The strategy seemed to work. In Florida, state health officials credited the campaign with dramatic drops in smoking rates among middle school and high school students. A similar trend was observed nationally. According to surveys by the U.S. Centers for Disease Control and Prevention, the proportion of students in grades 9 through 12 who smoked plummeted to 21.9 percent in 2003 from 36.4 percent in 1997.

But the good news began to drift away after funding for the national campaign expired and lawmakers in several states began shifting tobacco proceeds from anti-smoking programs to other projects.

Officials at the CDC say now that the decline in teen smoking appears to have stalled. After climbing to 23 percent in 2005, the proportion of teens who smoke hit a low of 20 percent in 2007 - roughly the same, statistically, as in 2003.

Health groups such as the Campaign for Tobacco-Free Kids - a coalition that includes the American Cancer Society and the American Medical Association - contend progress has stalled because states have cut funding for anti-smoking projects.

There could be contributing factors, of course. Given the history of tobacco use in our country, for example, just how realistic is it to expect the teen smoking rate to continue falling?

And what role do other factors, such as cigarette-tax increases and industry reductions in pricing, play in smoking rates?

There is reason to believe, however, that the anti-smoking campaigns carry a special punch.

In Florida in particular, teens who decided to pass up smoking indicated in state surveys that they had seen the graphic smoking-deterrence ads and had been swayed by them.

Two years ago, Florida voters overwhelmingly passed a constitutional amendment requiring the state to spend about 15 percent of its tobacco settlement each year, or roughly $58 million, on prevention programs.

Other states, struggling with budget constraints in a tough economy, aren't investing as much. Virginia included $14.5 million this fiscal year for prevention programs, $1 million more than a year ago but still well below the minimum of $38.9 million recommended by the CDC. North Carolina is spending $17.1 million - significantly more than fellow tobacco states - but still less than the CDC's suggested minimum of $42.6 million.

The tobacco industry, of course, isn't fond of anti-smoking campaigns, particularly ads that call attention to their own denials, over decades, that smoking causes cancer.

But teens seem to like the ads, and that's important. The public's stake in reducing tobacco use is huge; annually, smoking-related health care costs are $2.08 billion in Virginia and $2.46 billion in North Carolina.

Even in tough budget times, it's in the long-term financial interests of every state to stress to teenagers the immense power of nicotine addiction and the painful consequences of succumbing to it.