Jump in Teen Smoking Sparks Furor : Health: Activists blame government's whittling away of program funding, but the health department points to other factors.

By SHARI ROAN

Oct. 4, 1995 12 AM PT

TIMES HEALTH WRITER

Six years after the state launched a youth anti-smoking campaign that garnered international praise, a new analysis shows that smoking rates among teen-agers bulged in 1993-’94 after holding steady for three years straight.

Among California teens 12 to 17, 10.9% reported smoking recently--nearly 20% more than in the previous three years when 9.1% acknowledged smoking recently. (Nationally, studies show more than 18% of eighth-graders and about 25% of 10th-graders say they have smoked recently.)

The report, issued last week in Sacramento, was coupled with an announcement that the state Department of Health Services is kicking off a new program to address teen smoking. But that failed to pacify health activists who charge that the government took what was once a model program and blew it by whittling away funds.

The anti-smoking campaign began in 1989 with the support of Proposition 99 funds, which raised cigarette taxes. But since 1992, some Proposition 99 money has been diverted by Gov. Pete Wilson to shore up health-care programs that are underfunded.

“One of the real difficulties is that the Administration is in denial that their constant diversions have had any impact on the smoking increase and on our programs,” says Paul Knepprath of the American Lung Assn. of California. “They think the diversions aren’t hurting the program when, in fact, they are.”

Officials for the Department of Health Services, however, maintain that the increase in teen smoking is because of other forces. They note that the campaign has still spent nearly half a billion dollars over five years.

“There is no magic bullet, no panacea that will easily stem the tide of increasing tobacco use among teens in California--and merely throwing money at the problem will not solve it,” said state Health Director Kim Belshe in a statement Thursday.

Moreover, state officials say, any deleterious effects in diverting the funds would not have shown up so soon (in the 1994 data).

Several lawsuits are pending by organizations including the American Lung Assn. to halt the Proposition 99 diversions. One of those lawsuits was won by the health groups but has been appealed by Gov. Wilson.

Money originally intended for the tobacco education account--one component of the anti-smoking campaign designed to educate children about smoking--was cut by about half in the last fiscal year. Overall, the diversions of Proposition 99 amount to “hundreds of millions of dollars,” Knepprath says.

But the fact that smoking rates among teens declined from 1990 to 1993 while national rates increased shows the impact of the campaign during those years, Knepprath says.

“We can point to the Proposition 99 programs as one of the major reasons why kids were not lighting up like kids across the country were,” he says.

The Proposition 99 anti-smoking campaign has several components, including community-based smoking cessation programs, school-based education and a media campaign that attracted worldwide attention.

“You had a program that enjoyed immense public support, which was saving money in health care costs and was working. And this thing has been destroyed,” says Stanton Glantz, a professor of medicine at UC San Francisco who has studied smoking among youth. “This increase . . . is exactly what we expected since the governor has dismantled the tobacco education campaign. This increase is a direct result of the government’s actions. When you take a good thing away, bad things happen.”

Adult smoking rates in the state continue to fall, however, with only 15.5% reporting smoking in 1994. And, according to a Belshe spokeswoman, the increase among teens can be blamed on three factors.

“One is a reduction in cigarette prices that began in 1993 which makes it easier [for kids] to get the change out of their pockets,” says Lynda Frost of the Department of Health Services. “Second, a multimillion dollar ad campaign by the smoking industry to attract new smokers. And the access issue, which until now has not been as comprehensibly addressed.”

The “access issue” refers to the ease in which minors can purchase tobacco products from vendors who disregard the law, Frost says. The new state campaign is a four-part effort aimed primarily at reducing tobacco sales to minors.

The new campaign includes a toll-free number--(800) 5-ASK-4-ID--that enables consumers to report unlawful tobacco sales to youths. A recent state survey found that 37% of retail outlets were willing to sell tobacco to youths. Moreover, 90% of the stores did not display the signs required by state law concerning the sale of tobacco products to minors.

“It’s clear that we cannot rest on our laurels,” said Belshe in a statement. “The 1994 increase in teen smoking underscores the importance of redoubling our efforts to reduce the uptake of tobacco among our children, and that’s exactly what we’re doing with this new campaign.”

But critics are angered that the state has not acknowledged how the shift in Proposition 99 funds may have undermined the entire anti-smoking effort.

“I think, from the looks of this new campaign, that they are taking seriously one of the most important pieces that they need to attack--and that is the youth access issue,” Knepprath says. “But they also need to make prevention programs in schools and in communities active and viable so they can deliver a message to kids that smoking is not cool.”

Those are the two components of the anti-smoking campaign that have suffered the biggest reductions in funding, he says. The increase in youth smoking is most likely because of the diversions of Proposition 99 funds along with a surge in slick tobacco industry advertising aimed at youth, says Dr. John Pierce, a cancer researcher at UC San Diego who evaluated the effectiveness of anti-smoking campaigns for the state until 1994, when funding was severed for evaluation too.

According to Pierce, researchers predicted the surge in youth smoking. Statistics show that from 1975 to 1985, fewer people began to smoke. But the 1985 birth of the popular Joe Camel cartoon character was hugely appealing to kids and lured them into smoking, health experts say.

“All of our predictors were pointing the wrong way beginning in 1990,” Pierce says. “Half as many kids were stating [in questionnaires] that they thought staying away from cigarettes was important. They were saying that smoking cigarettes wasn’t a big issue.”

With diversions of Proposition 99 funds, the state’s health forces can’t hope to compete with tobacco industry advertisements and marketing gimmicks aimed at youth, he says.

“The tobacco industry has made major inroads with their marketing,” Pierce says. But of the state’s anti-smoking effort, he says: “Nothing has been done since ’93. There is no money. How can you have an innovative program and not do anything?

“What has happened is, the pro-health forces were spending about $40 million [in the anti-smoking health education component] at the start of the ‘90s. The tobacco forces are spending about $600 million. Suddenly, the state cuts the $40 million in half. What is the surprise? It’s hard not to agree with the Lung Assn.”

Glantz questions whether the Wilson Administration is committed to shoring up the program to its once laudable size. He criticizes Wilson’s “ties” to the tobacco industry, which include Craig L. Fuller, former senior vice president of the Philip Morris tobacco company who served as Wilson’s presidential campaign chairman, and Belshe, who worked as a lobbyist for the tobacco industry in the late ‘80s to defeat Proposition 99.

But Administration spokeswoman Kristine Berman notes that Wilson has shown a strong desire to curb smoking through his support of AB 13, legislation passed last year that prohibits workplace smoking.

“Gov. Wilson has been very consistent in his actions to protect Californians from the ill effects of smoking,” Berman says. “And Kim Belshe has been very aggressive in her approach to curbing smoking. Public health is her first priority, and she has been highly praised for her work.”