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Tobacco: The gateway drug

Ask any teenager: Tobacco is the first illegal drug-use they encounter. Underage smoking is often seen as a rite of passage towards adulthood, followed by underage drinking of alcohol. Tobacco is an addictive pastime leading to serious health consequences if used long term. It has been shown to be carcinogenic to the lungs when smoked and linked to mouth and throat cancers when chewed. Yet the culture of the tobacco smoker remains strong, as it has since its smoke was first introduced to the Europeans in ceremonial pipes by America's native people.

Tell me about tobacco use in America

The Washington Post, December 20, 2000 ; Page A03 © 2000 The Washington Post

Anti-Smoking Units Failed to Stop Teens

By Marc Kaufman

School-based programs that teach students how to resist social influences pushing them to smoke cigarettes -- long popular with states and more recently with tobacco companies -- have little effect and do not keep teenagers from smoking, according to a 15-year study released yesterday.

The research, which followed 8,400 students in Washington state from third grade to after high school graduation, found that those exposed to the anti-smoking curriculum were no more likely to resist smoking than students who did not receive the almost 50 hours of training.

"This approach was started 25 years ago and has been adopted in many school districts around the country," said Arthur V. Peterson, lead investigator on the National Cancer Institute-funded study undertaken by the Fred Hutchinson Cancer Research Center in Seattle.

"We were surprised and disappointed to see it did not produce the results predicted," he said. "The message from the study is clear: We can't rely on school programs alone to keep kids from smoking."

The program studied in Washington was based on the "best practices" guidelines promoted by the Centers for Disease Control and Prevention and the National Cancer Institute. It included activities such as a puppet play for third-graders on the dangers of secondhand smoke, role-playing for middle school students on how to turn down offers of tobacco, and for high schoolers reenacting testimony from landmark tobacco-liability trials about the industry's attempts to conceal the consequences of smoking.

Based on earlier research, the CDC has recommended that school-based programs be implemented along with aggressive anti-smoking media campaigns and other community-based efforts, using funds made available through the $246 billion national tobacco settlement. The anti-smoking efforts tested in the Washington study, however, were limited to the school programs alone.

Both the Philip Morris Cos. and Brown & Williamson have promoted school-based tobacco prevention programs, funding them for 250,000 teenagers in 18 states, including a statewide effort in West Virginia.

According to Philip Morris spokesman Brendan McCormick, the company researched which programs were most effective in reducing youth smoking and found that a program called Life Skills Training was widely respected. He said that the industry was funding both Life Skills programs and complementary anti-smoking media messages and after-school programs for students.

According to the new study, however, the program used in Washington state was more extensive than Life Skills. It sought to give students a clear idea of the prevalence of tobacco use and its health dangers, and to prepare them to resist peer pressure to try cigarettes.

The study followed the same students from third grade to high school graduation and found no positive effect from the program. Because of the breadth and depth of the study, researchers said it was now the "gold standard" for assessing tobacco prevention programs.

"Although the study demonstrated that this approach had no effect, it provides a valuable contribution to our knowledge about smoking behavior," said National Cancer Institute Director Richard Klausner. "Carefully conducted studies such as this one help us to understand what works and what does not in the area of youth smoking."

Matthew Myers, president of the Campaign for Tobacco-Free Kids, said the results raise questions about the tobacco industry's support of similar efforts.

"The type of program studied here is precisely the kind which the tobacco industry has been offering as a substitute for the kind of comprehensive effort that all experts agree is necessary," he said.

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