UP IN SMOKE

Anyone who has ever watched a 3-year-old child's eyes get as big as quarters
would know Connor McDermott's unabashed joy.

"Hey, Dad, look, it's a camel!" he said one fall day.

The problem is, Connor's words of excitement came while entering a
convenience store, and not the camel exhibit at the Brookfield Zoo, close
enough to the McDermott family home for regular visits.

"It was a cutout of Joe Camel," said Sean McDermott, Connor's father and a
top official at the Cook County Department of Public Health. "Lots of
tobacco promotions are eye-level at children's heights. The cigarette
companies know what they are doing."

Such as helping to persuade more kids under 18 to smoke today than in 1990.

The federal government reports that 36 percent of high school students
smoke, a number equal to 1979 statistics when tobacco advertising was less
regulated and health concerns about tobacco were not as pervasive. About
3,000 American teenagers-1,600 girls and 1,400 boys on average-each day
become regular smokers.

About one-third of teenagers who smoke regularly today will eventually die
from tobacco-related causes. What's more, new studies show adolescent
smokers appear to be more susceptible than smokers who start later in life
to long-term DNA damage associated with lung cancer, a disease rarely found
in 1930 and that now kills more U.S.
women than breast cancer.

But the youth tobacco problem in this country runs even deeper. The federal
Centers for Disease Control and Prevention (CDC) estimates a quarter of 8th
graders have smoked in the last month, 40 percent have used tobacco in the
last year and 15.5 million children are exposed to secondhand smoke in their
homes.

Although the Supreme Court in April agreed to decide in the next year
whether the government, specifically the Food and Drug Administration, can
regulate tobacco as a drug and cigarettes as drug-delivery devices, there
should be no waiting to discourage children from smoking.

"Start talking to children about the negatives of tobacco by age 4 or 5,"
said McDermott, who leads the suburban effort to enforce the 1997 Cook
County Youth Tobacco Control Ordinance that cracks down on vendors who sell
to minors. "One goal is getting kids through high school without smoking.

"Eighty percent of all adult smokers started before 18. We see 8th graders
and high school freshmen who are addicted to cigarettes; they can't wait for
class to end to get a smoke."

Research indicates the optimal age to impress children in a formal
prevention program is 10 to 11, when they are old enough to digest the
information (and face imminent peer pressure) but still base their decisions
mostly on adult input. Programs for younger kids prove less effective,
though parents need not hesitate to educate their children whether younger
or older. Studies show even parents who smoke can still persuade their kids
not to smoke by delivering a clear message about the health hazards of
tobacco and expressing regret about starting themselves. In one study, such
parent-smokers were nearly four times more successful (33 percent compared
to 9 percent) than parent-smokers who were indifferent to a teenager's
tobacco habits.

Activists contend the most effective anti-smoking youth campaigns are
comprehensive, using a variety of methods to reach kids rather than picking
a single strategy. The issue is timely because 46 states will be receiving
the first payments from the huge tobacco industry court settlement in the
summer of 2000. Illinois looks to receive somewhere between $64 million and
$176 million, but state legislators have made no decisions about how to
spend the money or if any of it will be designated for anti-smoking efforts.

"It's frustrating because we can see such high potential for stopping the
problem," said Alan Markwood, coordinator for the Illinois Youth Study
research project and director of prevention programs at a Bloomington
substance abuse center.

"There are states already producing significant reductions in youth
smokers," said Corinne G. Husten, medical officer with the Office of Smoking
and Health at the CDC in Atlanta. "We don't know what individual programs
are best, but the combination of media advertising, community and school
programs and policy intervention such as minor access seems to be working
quite well."

Florida has decreased smoking incidence among middle schoolers by 19 percent
in one year. Some observers credit a series of clever television and print
ads, devised with advice on content and placement from a committee of kids.
Others point to a 55-cent increase in the price of cigarettes and cite
research that smokers under 18 are twice as likely to be deterred by price
as adults.

"My favorite Florida ad was what I call `Oscars From Hell,' " said Bill
Novelli, president of the private National Center for Tobacco-Free Kids and
founder of one of the nation's largest public relations agencies. "All of
the worst deaths were nominated, such as AIDS, murder, suicide and tobacco.
Tobacco wins. A guy in a tuxedo
grabs the Oscar and says, `For all of you smokers, this one's for you.' "

California is another state with a lively media campaign. One ad shows a
herd of smoking cowboys being led into a corral. Another depicts a
smoke-filled board room of executives joking about not "being in it for the
money but the addicted kids."

Massachusetts has chosen to use fear as a weapon--one TV spot involves a
young mother who needs a lung transplant but probably won't get it--while
Arizona's approach is aimed squarely at peer pressure, running ads that
associate smoking with bad breath, smelly hair andinability to get a date.

Markwood noted each ad category reaches different kids--or the same kids at
different times in their lives--and shouldn't be filtered out by adults who
think health hazards represent the only proper message.

Another issue is simply acknowledging that a child might be smoking.
Communication between parents and their teens is the most important
preventive measure, even if the talk is focused more on parental authority
than on why tobacco is bad for the lungs and body. A Rutgers University
research analysis showed teenagers with low expectations of punishment were
significantly more likely to become regular smokers than kids who
anticipated losing privileges if caught smoking. The seemingly obvious
action of setting no-smoking rules at home--compared
to having no stated policy--produces fewer teen smokers.

High schools are contributing their own dose of honesty to the disturbing
youth tobacco problem.

"When I went to school (in Rockford), we had a smoking lounge for students,"
said Robin Muff, an art teacher and co-coordinator of student assistance
programs at Zion/Benton Township High School. "Now, of course, the teachers
don't even have one. But it doesn't mean kids aren't smoking. Our programs
are there for kids who want to quit but have trouble on their own."

The smoking cessation groups at Zion/Benton High meet for eight weeks and
follow a course syllabus developed by the American Lung Association, which
also runs a Teens Against Tobacco Use (TATU) group that has trained about
400 Chicago-area smoke-free high school students who volunteer their time to
speak with grade school classes.

An overwhelming number (95 percent) of teenagers think they will quit
smoking by 25," said Janet Williams, a spokeswoman for the Lung Association.
"But most of them (75 percent) are still smoking seven to nine years after
high school."

Consequently, the money and industry limitations of the multistate
settlement agreement shouldn't be categorized as spoils of victory, Novelli
said. The recent elimination of billboard advertising is expected to help;
so will prohibition of brand-name merchandise such as hats or T-shirts
except at tobacco-sponsored events, which have been curtailed but not
eliminated. But tobacco companies can still place outdoor advertising on
signs 14 square feet or smaller on buildings or property where tobacco is
sold, including stores near schools. There is no limit on cigarette ads in
newspapers and magazines, leaving it up to individual publishers. There are
also no restrictions on Internet advertising or Web site promotions.

"Tobacco advertisers are sending strong subliminal messages to kids despite
their denials," Novelli said. "These companies spend hundreds of millions
aimed at kids.

"The companies know what interests the kids and how to communicate those
interests. (The kids) are interested in love. They're interested in
rebelliousness. They're interested in adventure seeking. They're interested
in sex. These are all part of the images."

A new study commissioned by the U.S. Department of Health and Human Services
makes the case for targeted youth marketing. It showed 70 percent of white
12th-grade smokers prefer Marlboro and 80 percent of African-American
12th-grade smokers choose Newport. Those two brands, plus Camel, are the
three most heavily advertised products.

While Camel holds a lesser but nonetheless significant share of teen
smokers, one survey showed more than 90 percent of 6-year-olds recognize the
recently "retired" character, Old Joe.

"The tobacco industry won't stand still," said Hubert Humphrey III, the
former attorney general of Minnesota and one of the first attorneys general
to initiate a lawsuit against tobacco manufacturers. "It will only become
more aggressive."

One concern about tobacco companies is whether they will continue to
manipulate nicotine levels in cigarettes. Nicotine is not necessarily
harmful but is an addictive substance that hooks smokers early in their habits.

"Tobacco companies have known since the 1970s how to increase the nicotine
effect," said Jack Mitchell, the FDA commissioner's special assistant for
investigations. "They can use ammonia to increase the bioavailability of the
nicotine. It's one of the secrets to why Marlboros have been so popular."

Husten said nicotine technology can be used positively, especially if
parents are willing to forgive children for starting smoking and help kids
join peer support groups and other options.

"Stop-smoking programs are one of the most cost-effective health measures we
have in this country," she said. "(Compared to 10 years ago), we have better
counseling methods and more effective medications."

Mitchell said FDA investigators also uncovered documents prior to the
settlement that showed tobacco companies were researching tendencies of
consumers as young as 5.

It makes people such as Alan Markwood and Sean McDermott make no apologies
about working overtime to stop kids from smoking.

"The private industry wants to contest whether tobacco is a `gateway' drug,"
Markwood said. "It's not as simple as saying if you take one drug, then you
take another. But the fact is, hardly anyone who uses controlled substances
such as cocaine or heroin hasn't started with tobacco, alcohol or dope.
Usually it's all three."