SUMMARY. In this volume, we will examine different components of a preventive public health intervention directed at reducing rates of youth smoking. The rationale for this intervention is presented as well as a review of the literature on this topic. Five data-based papers will provide readers with an overview of different aspects of this large community-based preventive intervention. One paper will examine the types of ordinances that communities have adopted and what our recommendations are for optimal tobacco control policies at the local level. A second 2paper will examine the readiness of communities to begin the process of changing, and how that might be documented. Another domain we will investigate is whether the types of tobacco prevention programs in schools have an effect on youth smoking rates. We will also provide data about what influences a store merchant to actually illegally sell tobacco to minors. Finally, we will investigate whether youth who participate in tobacco purchase efforts become more likely to try smoking or whether their attitudes change as a function of participating in these programs. We conclude that effective programs are more likely to be comprehensive, sustainable, well planned, and coordinated at the local level. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <[email protected]> Website: <https://www.HaworthPress.com" xmlns:xlink="https://www.w3.org/1999/xlink">https://www.HaworthPress.com> © 2002 by The Haworth Press, Inc. All rights reserved.]
Researchers have long grappled with the problem of reducing tobacco use as a way of optimizing the health and well-being of communities (Rhodes & Jason, 1988). From the early to the mid 1990s, current smoking, defined as having smoked in the past 30 days, increased from 27.8% to 34% for high school students, and increased from 15.5% to 21% for eighth graders (Johnston, 1996). Even though rates have begun to decrease 1 to 3 percentage points in the last few years, rates of smoking among American teens remain very high (Johnston, Bachman & O'Malley, 1998). Every day, 3,000 American adolescents begin smoking (Pierce, Fiore, Novotny, Hatziandreu, & Davis, 1989), and it is estimated that 1,000 of these children will eventually die of tobacco-related illnesses (Centers for Disease Control, 1996).
Smoking is the leading preventable cause of death in the United States, killing over 400,000 people each year. This is more people than die each year of acquired immune deficiency syndrome, homicide, suicide, automobile accidents, illegal drug use, and fires combined. The direct medical costs of treating tobacco related diseases in the United States are estimated at $50,000,000,000 per year (Centers for Disease Control, 1996). The amount of human pain and suffering caused by tobacco use is immeasurable. Despite these facts, 22.9% of adult Americans and 13.8% of Americans under the age of 18 smoke cigarettes (Centers for Disease Control, 1996).
3The findings above strongly indicate that preventing youth smoking initiation is the most effective way to reduce long-term mortality from heart disease, cancer, chronic lung disease, and other tobacco-related disorders. There will always be some children and adolescents who use; the key question is whether there are behavioral and social data that indicate a way to reduce the number of children who begin this deadly habit. The most effective policies might be those that are universal interventions that both reduce youth access to tobacco products and promote tobacco-free norms through taxation of tobacco products, regulation of tobacco products, enforcement of youth access laws, constraints on advertising and promotion, and tobacco control advocacy for tobacco-free environments (Jason, Biglan & Katz, 1998). It is beyond the scope of this article to review all of these preventive policies, and below we will focus on the potential of curtailing youth access to tobacco.