
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, October 3, 1994                   TAG: 9410040005
SECTION: EDITORIAL                    PAGE: A-7   EDITION: METRO 
SOURCE: PAUL R. TORRENS
DATELINE:                                 LENGTH: Medium

SWITCH THE FOCUS

BY THE time you pick up tomorrow's newspaper, an estimated 3,000 more young people will have become regular smokers. Encouraged by a near-constant stream of pro-tobacco messages, they will have taken the first tentative steps toward lifelong addiction. It is an addiction that eventually will kill many of them.

Cigarette smoking is the leading cause of avoidable death in our country. The use of tobacco leads to more deaths than do AIDS, automobile accidents, suicides, homicides, fires and illegal drugs combined - nearly 400,000 per year. Yet the federal government devotes relatively little attention to this public-health disaster. And it spends even less effort preventing tobacco use in the sector of society where it could do the most good: among children and adolescents. Chronic, long-term cigarette smoking almost invariably begins in a person's teen-age years.

If people have not begun using tobacco by the age of 18, they are very unlikely to pick up the habit later. Children and teens are particularly susceptible to advertisements and other messages that promote smoking. They lack the experience and judgment to appreciate the grip of nicotine addiction, and they are not in a position to understand fully the consequences of lifelong smoking.

By focusing on adults, the government confronts the problem long after it has started and has become an addiction. Meanwhile, the use of tobacco by youths has remained stubbornly constant for more than a decade and may be rising. The focus of our tobacco-control policies must be on preventing children and youths from becoming addicted to nicotine in the first place.

There is no single answer to the question of how to discourage tobacco use among the young, but a multifaceted approach could have great impact.

First, Congress should substantially increase the excise tax on tobacco products. Boosting the tax - say by $2 per pack of cigarettes, with similar increases for smokeless tobacco products - would make tobacco less affordable to youths, while raising money for tobacco control, health care and other health-related uses.

The federal government also needs to do a much better job of supervising and regulating the production of nicotine-containing tobacco products. An appropriate agency within the U.S. Public Health Service should have the authority to strengthen health warnings on tobacco products and to regulate the nicotine levels of tobacco products. Federal agencies have removed far less dangerous products from the market because of potential harmful effects. It is time to control the availability of nicotine-laden products to young children.

Federal law prevents state and local governments from regulating tobacco advertising that occurs entirely within their jurisdictions, such as billboards and storefront displays. Congress should repeal that law. Within the next few years, Congress and state legislatures should also eliminate all features of tobacco advertising and promotions that tend to encourage children and youths to use tobacco. Similarly, all public locations frequented by young people - including schools, sports arenas, malls, fast-food restaurants and transit systems - should adopt and enforce tobacco-free policies.

Many states and cities are ready to move aggressively to curb tobacco use and nicotine addiction among children and adolescents in their communities, but they have neither the funds nor the expertise to do it alone. The federal government should increase its support for state and local efforts to pursue youth-centered control policies. Technical assistance, grants and cooperative agreements could all help local governments discourage the use of tobacco.

By taking these steps, government can help to reinforce the tobacco-free norm that is emerging in our society. In the past, many people felt smoking to be acceptable and even attractive. But society is now beginning to see tobacco use for what it is - a dangerous, expensive addiction that should be prevented.

If we as a nation are really interested in improving our collective health, curtailing tobacco use must be one of our top priorities. And to prevent chronic tobacco use, we must deal with the problem when and where it begins: in childhood and adolescence.

Paul R. Torrens, professor of health services administration at the University of California, Los Angeles, chairs the Institute of Medicine's Committee on Preventing Nicotine Addiction in Children and Youths.

by CNB