How do you convince kids not to smoke?
That's the question of the moment for educators, health activists -- and the tobacco industry.
While educators struggle to reduce smoking rates among youth, which is the only segment of U.S. society in which smoking has not declined in the past decade, the tobacco industry is promoting its own anti-smoking program this summer in a 30-city tour punctuated with public service announcements on radio, television and billboards.
As one industry official puts it: "We all agree kids shouldn't
But the industry's involvement in delivering the message has many anti-smoking activists enraged. They claim its method of educating youth about tobacco is inappropriate and misleading.
The material in question includes a free brochure produced by the Tobacco Institute, an industry group, entitled, "Tobacco: Helping Youth Say No," and public service announcements carrying the message, "Smoking should not be a part of growing up."
Also challenged is a youth-oriented program, called "Right Decisions, Right Now," produced by R. J. Reynolds Tobacco Co.
Both programs emphasize only adults should choose whether to smoke -- an approach many health educators say fails.
The campaigns do little more than give the industry an appearance of public responsibility in order to gain favor with legislators who could further restrict cigarette advertising and marketing techniques, industry foes say.
"We don't feel the effort on behalf of the tobacco industry is sincere," says Michael Eriksen, director of the U.S. Office on Smoking and Health. "[The material] falls short of what we feel is important in getting kids not to use tobacco."
But, says industry spokesman Peter G. Sparber: "There are people who are simply offended that the tobacco industry is even funding this."
The war of words became particularly heated this summer when a harsh critique of the industry material was published in the June issue of the Journal of Family Practice:
" 'Tobacco: Helping Youth Say No' will turn teachers and parents into unwitting accomplices in addicting another generation of children to nicotine," wrote physicians Joseph R. DiFranza and Tim McAfee, anti-smoking activists.
Drs. DiFranza and McAfee object to the advice given to parents that "your children should be involved in the decision not to smoke." The booklet suggests parents tell their children: "Some adults may choose to smoke but there are many activities in which young people shouldn't participate."
But, say the doctors, children who might never have considered smoking are taught that they must make a decision about it: "Not surprisingly, some decide to try it."
"With things that are important we don't give kids the choice," Dr. DiFranza said in an interview. "We don't ask them whether or not they want to have a tetanus shot or whether or not they want to attend school."
The booklet does not contain information about the health risks of smoking for either children or adults. Instead, smoking is portrayed as an adult activity, Dr. DiFranza charges.
"What could make smoking more appealing to a teen-ager than to portray it as a rite of passage into adulthood?" the authors ask.
Another public service message, "Smoking should not be a part of growing up," and the tobacco industry's "It's the law" poster and billboard campaign -- meant to remind retailers that tobacco products cannot be sold to minors -- also backfire, says Julia Carol, co-director of the Berkeley, Calif.-based Americans for Nonsmokers Rights.
The "It's the Law" campaign at best has no effect and at worst is bad, she says: "Being told you're not allowed to do something and that it's an adult activity, well, they might as well be saying to kids, 'I dare you.' "
But, according to Mr. Sparber, the "Tobacco: Helping Youth Say No" brochures fill an important void in the youth tobacco-control field. The material is designed to help parents talk openly with their children about any sensitive topic, he says. About 290,000 brochures have already been distributed.
While smoking rates among adults continue to decline, rates have remained stable among youths. In 1989, the most recent year for a federal survey, 16 percent of males and 15.3 percent of females ages 12-18 admitted smoking in the past month. Among 18-year-olds, 29.1 percent of boys and 21.3 percent of girls smoked weekly. More white youths smoke than blacks or Latinos.
Tobacco industry officials vigorously deny they advertise to youth and say they support measures aimed at stopping youths from smoking.
But, says Michelle Bloch, a Washington health policy consultant and ardent tobacco industry foe, "the tobacco industry's posture has been that we don't want kids to smoke. We know that is a bald-faced lie.
"They lose 2.5 million customers every year; those who quit and those who die. You have to replace those people every year just to stay in business," she says.