Pubdate: Wed, 09 Aug 2000 Source: St. Petersburg Times (FL) Copyright: 2000 St. Petersburg Times Contact: http://www.sptimes.com/ Forum: http://www.sptimes.com/Interact.html Section: Front page Author: Wes Allison, Times Staff Writer TEEN SMOKING IN FLORIDA PLUNGES Researchers Credit the State's Aggressive, $44-Million Anti-Tobacco Campaign With Changing Attitudes Smoking among Florida teenagers has dropped dramatically since the state launched an anti-tobacco program three years ago, suggesting that a well-financed, coordinated campaign can snuff out cigarettes, the current issue of the Journal of the American Medical Association reports. Florida's Pilot Program on Tobacco Control was singled out Tuesday as an example for other states at the American Medical Association's 11th World Conference on Tobacco or Health, being held this week in Chicago. A survey of more than 23,000 Florida teens showed smoking has declined by 40 percent among middle school students and by 18 percent among high school students since 1998, according to an article in Tuesday's issue of JAMA whose authors include Florida Secretary of Health Robert G. Brooks. That was the year the state began running edgy anti-smoking ads and cracking down on cigarette sales to minors. The plunging numbers shocked even those who run the program. State officials attributed the massive drop among middle schoolers to getting their message across to younger children, who apparently are eschewing tobacco at an age when many current smokers first began to consider it. They also predicted smoking among high schoolers would continue to drop as today's middle schoolers advance. "Those are the kids who are coming up through elementary school and entering middle school, and they're not seduced by cigarettes the way kids were years ago," said Dr. Ursula E. Bauer, the chronic disease epidemiologist for the Florida Department of Health and the lead author of the JAMA article. "We're documenting these decreasing trends over time, which is very exciting." This is significant because 85 percent of smokers started as teenagers. If public health officials can stem youth smoking, they think they can significantly cut smoking and the expensive medical problems smokers develop. The government estimates that 400,000 Americans die from smoking each year. As an epidemiologist, Bauer is responsible for tracking the numbers and does not work on the state's program. And she remains a bit skeptical that the program could be responsible for the dramatic declines. But numbers in Texas and Mississippi, which began asking teens about smoking at the same time, do not show decreases in smoking. And, the JAMA article notes, smoking among teens nationally has not dropped in the past three years. "We're seeing results in Florida that we're not seeing in other states, so there's something going on in Florida that's not going on elsewhere," Bauer said. "We think it's the program." Bauer and Debra Bodenstine, director of the health department's Division of Health Awareness and Tobacco, were in Chicago Tuesday to share the survey and the program with others at the conference, which drew 5,000 public health officials and researchers from around the world. The data and the recognition mark a major coup for the teen smoking program, which faced an uncertain fate in the state Legislature this session. Ultimately, it got the same money as in 1999, about $44- million. The funding comes from the state's $11.3-billion settlement with the tobacco industry. Other states have comprehensive anti-smoking efforts, but none are as extensive as Florida's, said Dr. Harmon Eyre, the chief medical officer for the American Cancer Society, which is co-sponsoring the Chicago conference. None are as expensive, either, he added, noting that Florida outspends most states by 10- or 20-to-1 per student. But states that want results like Florida's will have to spend like Florida, he said. "You can't do a very small campaign with limited resources and have a major impact," Eyre said Tuesday from Chicago. "It's become very clear, and perhaps the Florida campaign has crystalized this, that ... if you put in the right amount of resources, you reach the right market." Marketers, and savvy public health workers, also realize adults don't play cool well; it's tough to reach young people without sounding preachy, condescending or simply goofy. Bodenstine said a key part of Florida's campaign is the edgy, in-your-face TV and print advertising designed by teens, for teens, featuring the slogan, "Our brand is truth, their brand is lies." The ads generally paint the tobacco mavens as manipulative demons, and are meant to combat the glamorous images perpetuated by fun-loving, fit-looking men and women in cigarette ads. And the message is proving popular: Among the 12- to 17-year-olds surveyed last year, a whopping 92 percent could describe a theme from "Truth." The campaign also includes beefed-up enforcement of the ban on tobacco sales to minors and tobacco prevention coordinators in each of the state's 67 counties. According to the JAMA article, the state surveyed 22,500 students in 1998, just before the program started, and 21,000 and 23,700 students in 1999 and 2000, respectively. Current cigarette use among middle school students dropped from 18.5 percent to 11.1 percent, and from 27.4 percent to 22.6 percent among high school students. "Current use" is defined as smoking at least one day within the past 30. Nationally, 34 percent of high school students are considered current users, according to the U.S. Centers for Disease Control and Prevention. Meanwhile, Florida students who reported never using tobacco jumped from 56 percent to 69 percent in middle school and 32 percent to 43 percent in high school. The state's survey methods and results were audited by the University of Miami and reviewed by AMA experts before publication. Bodenstine said her office will begin bringing the campaign to Florida's public colleges this fall, and at least one new study shows students can use the help: According to a Harvard University report also published in this week's JAMA, 45 percent of U.S. college students used tobacco in the past year, and 33 percent currently use it. Cigarettes are most common, but smokeless tobacco and cigars are also popular. - --- MAP posted-by: John Chase