Misleading headlines and MMRW at a loss for ideas

First of all the misleading headline:

US Teen Smoking On The Rise Again?

And what does this headline represent? “The rate at which US high school students used cigarettes fell from 36 percent in 1997 to nearly 22 percent in 2003, but then the rate of decline slowed sharply, a report by the Centers for Disease Control and Prevention (CDC) said.” Apparently some kind of new math turns a slow decline into a rise.

It would be instructive to run a test on what people remembered after reading this article. Suspect that the fearmongering headline would carry the day.

Keeping fear at center stage is evident in the source for the news item, the MMRW report, which despite being about a small but steady decline in teen smoking in the last few years (positive news one would think). But as witness the following passage, this is still not good news.

The impact of tobacco advertising and promotion activities on youth smoking initiation has been documented previously (8). The increase in current cigarette use among high school students during the early to mid-1990s observed in this and other surveys might have resulted from expanded tobacco company promotional efforts, including discounted prices on cigarette brands most often smoked by adolescents, depictions of tobacco use in movies, distribution of nontobacco products with company symbols (e.g., hats and T-shirts), and sponsorship of music concerts and other youth-focused events (7). Reductions in advertising, promotions, and commercial availability of tobacco products should be combined with expanded counter-advertising mass media campaigns and implemented with other well-documented and effective strategies (e.g., higher prices for tobacco products through increases in excise taxes, tobacco-free environments, programs that promote changes in social norms, and comprehensive communitywide and school-based tobacco-use prevention policies)(2–5).

We see that the previous short rise in teenage smoking in the mid90s was interpreted to be due to tobacco advertising and commercial availability. Let’s say that’s true. Since then there has been a steady erosion of tobacco advertising and availability not to mention massive price increases, greater surveillance of shops and millions of dollars poured into public service messages about why smoking is bad for you. Some of these things have probably contributed to the smoking rates falling but we are nearing the end of how far you can push those solutions.

Already we have seen an increase in the black market thanks to the price increases, or as in Canada, removing flavoured cigarellos from legitimate dealers. Recent Canadian studies have found that not only do youth get a sizable portion of their tobacco from the black market but that overall they get most of their tobacco not from stores but from acquaintances or family.

Of course, we all agree that we don’t want kids smoking and these declines are good news. But to use some confusing interpretation with a negative spin just to maintain the same playbook, the one that is growing the black market and also undermining any substantial harm reduction, seems like just a blatant ploy to keep money pouring into antiquated programs that are out of step with the rest of public health.

Their goal has remained making nicotine use more difficult when it should be about making it safer. But I guess that’s not where the money is.

– Paul L. Bergen

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