Decline in reducing youth smoking and increase in smokeless tobacco use

Campaign for Tobacco-Free KidsDec 15 2009

Following is a statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids:

The 2009 Monitoring the Future Survey released today by the National Institute of Drug Abuse shows that the nation continues to make gradual progress in reducing youth smoking, but declines have slowed significantly compared to the dramatic gains early in the decade. In especially troubling news, the survey also finds that smokeless tobacco use has increased among 10th and 12th graders in recent years, a period during which tobacco companies have introduced a slew of new smokeless tobacco products and significantly increased marketing for smokeless tobacco.

There is no question that we know how to dramatically reduce youth tobacco use. The use of proven strategies has caused smoking rates (the percentage who have smoked in the past 30 days) to decline by 69 percent among 8th graders, 57 percent among 10th graders and 45 percent among 12th graders since peaking in the mid-1990s. This is a remarkable public health success story. Before the recent increase, youth smokeless tobacco use also declined significantly from the mid-1990s to the early 2000s. However, the much slower progress in recent years is a clear warning to elected officials at all levels that they must resist complacency and redouble efforts to implement proven measures - rather than cutting tobacco prevention programs, as 34 states did this year. It is unacceptable to stand still or risk backsliding in the fight against the nation's number one preventable cause of death. It is also unacceptable that one in five high school seniors still smoke (according to the survey, 20.1 percent of 12th graders, 13.1 percent of 10th graders and 6.5 percent of 8th graders reported past-month smoking in 2009).

In addition to the lack of further progress in reducing youth smoking, the increase in smokeless tobacco use among youth is very troubling. According to the survey, there have been significant increases in smokeless tobacco use among both 10th and 12th graders in recent years. The percentage of 12th graders reporting past-month smokeless tobacco use increased from 6.1 percent in 2006 to 8.4 percent in 2009 (a 38 percent increase), while the percentage of 10th graders reporting smokeless tobacco use increased from 4.9 percent in 2004 to 6.5 percent in 2009 (a 33 percent increase).

This increase coincides with the introduction of numerous new smokeless tobacco products and a big increase in smokeless tobacco marketing. In recent years, the top two U.S. cigarette manufacturers, Philip Morris and R.J. Reynolds, have entered the smokeless tobacco market both by purchasing existing smokeless tobacco companies and introducing new smokeless tobacco products. These new products have included Marlboro snus and Camel snus that married the names of these companies' best-selling and most youth-popular cigarette brands to spitless, pouched smokeless tobacco products called snus. In 2008, R.J. Reynolds began test-marketing new dissolvable smokeless tobacco products called Camel Sticks, Strips and Orbs that look like gum and candy and come in "fresh" and "mellow" flavors. These new products no doubt appeal to kids because they are easy to conceal, carry the names of youth-popular cigarette brands and come in candy-like forms and flavors. In addition, more traditional smokeless tobacco products continue to be marketed in a wide variety of kid-friendly candy and fruit flavors.

There has also been a big increase in smokeless tobacco marketing. According to the latest data from the Federal Trade Commission, smokeless tobacco marketing expenditures totaled $354.1 million in 2006, an increase of 53 percent since 2004 and 143 percent since 1998. Smokeless tobacco marketing rose even as cigarette marketing fell slightly from 2003 to 2006. While most cigarette brands have stopped advertising in magazines with large youth readerships such as Sports Illustrated and Rolling Stone, many smokeless tobacco brands continue to advertise in these publications, most notably R.J. Reynolds' Camel snus. Also, more than 60 percent of smokeless marketing is spent on price discounts (including coupons) that make smokeless tobacco products more affordable and appealing to price-sensitive youth customers.

The Monitoring the Future survey also found a decrease in recent years in the percentage of 10th and 12th graders who perceive regular smokeless tobacco use as a great risk to health. This decline in risk perception comes as some smokeless tobacco companies have sought to portray their products as a less hazardous alternative to cigarettes. Rather than reducing the harm caused by tobacco use, today's survey indicates that the main consequence of current smokeless tobacco products and marketing is to increase the number of youth who use smokeless tobacco. That is bad news for health because smokeless tobacco is far from harmless. Smokeless tobacco, as traditionally sold in the U.S., has been found to increase risk of oral cancer, gum disease and cardiovascular disease. Constant exposure to tobacco juice has also been linked to cancer of the esophagus, pharynx, larynx, stomach and pancreas.

The Monitoring the Future survey underscores the need for elected officials at all levels to step up the fight against all forms of tobacco use. Congress and President Obama have taken major strides this year by approving a 62-cent increase in the federal cigarette tax and enacting the new law granting the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products and marketing. The survey results do not reflect the full impact of the cigarette tax increase, which took effect April 1, in the middle of the survey period. There is evidence that the cigarette tax increase has had a significant impact. Manufacturers reported a 10 percent decline in cigarette sales in the third quarter of this year. The new FDA law took effect June 22 and will be implemented over several years.

There are many additional steps Congress and the states must take:

• The pending health care reform legislation presents Congress with an immediate opportunity for action. It is vital that health care reform include robust funding for community-based disease prevention initiatives, including tobacco prevention and cessation. Congress should also require coverage for smoking cessation therapies in Medicaid and other health insurance programs.
• States must invigorate their efforts to implement three proven strategies: higher tobacco taxes, smoke-free workplace laws and well-funded tobacco prevention and cessation programs. Unfortunately, as a report released last week by the Campaign for Tobacco-Free Kids and our partners showed, the states have cut funding for tobacco prevention programs by 15.4 percent this year and are spending barely two percent of their $25.1 billion in tobacco revenue to fight tobacco use. Instead, states should hike tobacco taxes to help fill budget gaps and use some of the revenue to fund tobacco prevention programs. As the new survey underscores, states should increase tax rates on smokeless and other tobacco products to match those on cigarettes so that differential rates do not encourage kids to use cheaper-priced tobacco products.

Tobacco use causes more than 400,000 preventable deaths and costs the nation nearly $200 billion in health expenditures and lost productivity each year. We know what works to reduce tobacco use among both youths and adults. What's needed is the political will to implement these solutions as aggressively as the tobacco industry promotes its deadly products.

More information on the Monitoring the Future survey can be found at www.monitoringthefuture.org.