A new wrinkle in the war on teen smoking

Back when I was in high school, one of the hottest issues on many high school campuses was whether to provide students with a smoking lounge.

Then as now, school officials, and society in general, didn’t approve of teen tobacco use. There seemed to be an unspoken level of tolerance, however. It was commonplace for kids who smoked to light up in the school building or on school property. As I recall, the bathrooms across the hall from the principal’s office were where the smokers at my high school always hung out. The air reeked so strongly of cigarette smoke that the rest of the students wouldn’t set foot inside.

Give the kids their own smoking lounge and they can smoke to their heart’s content without bothering their classmates, or so the thinking went.

It would be hard to imagine any high school nowadays even contemplating such a thing. Policies are much more stringent about tobacco use on high school campuses, and teen smoking rates are down significantly compared to even 15 years ago.

It’s a constantly moving target, though. And one of the latest wrinkles comes from a direction I’m not sure anyone would have anticipated: In the push to curb youth obesity, we may be unwittingly shifting the focus away from youth tobacco prevention.

That’s one of the premises, at least, of a couple of intriguing articles that appeared late last week in the New York Times. The U.S. has fallen short of its goal to lower the number of high school-aged youths who smoke, the first article notes:

"People are getting the image that it’s cool to use nicotine as a drug," Terry F. Pechacek of the Centers for Disease Control and Prevention said in an interview. "We need to bring back our voice, our antismoking mass media campaign."

The popularity of hookah bars and smokeless nicotine products, Mr. Pechecek said, are the modern equivalent of the banned Joe Camel cartoon in their appeal to youths. And some experts worry that the new health campaign against obesity – spearheaded by Michelle Obama from the White House – may be hampering donations to antitobacco campaigns as public health issues shift in emphasis and compete for funds.

A second article poses the question more bluntly: "If you had to choose one public health problem to attack, which would it be: teenage smoking or childhood obesity?"

When the scientific evidence is weighed, the benefits of youth tobacco prevention are more firmly established, the article points out. For one thing, contrary to what many among the public might believe, the death toll from obesity has been difficult to accurately pin down. The death toll from tobacco, on the other hand, has been relatively well documented.

For another thing, the article points out, intervention strategies and their long-term benefits are harder to measure for childhood obesity prevention than for tobacco prevention:

Even if it were possible to calculate the lifetime health risks a fat child faces, combating obesity is not so easy. Jeffrey Friedman, an obesity researcher at Rockefeller University, notes that there are many assumptions about what will work – more healthful foods in schools, a soda tax, getting children to be more active. Yet no interventions, when tested in large studies, have caused a big difference in children’s or teenagers’ weights.

There’s the addiction component as well. There can be many reasons why children are obese, and so-called food addiction is only one – and probably not even the most prevalent. Few could argue with any scientific validity, however, that nicotine is not addictive; indeed, it’s one of the factors that makes the habit so hard to quit for so many people.

It all makes you wonder why it has to be either-or. Should ramping up the war against childhood obesity have to be at the expense of youth tobacco prevention? Why can’t there be room in the prevention tent for both?

To the extent that we no longer talk about smoking lounges for high school students, there has been measurable change in how teen tobacco use is regarded. But if the fact that close to 20 percent of American teens still smoke is any indication, there’s room for improvement yet. On the front lines of youth tobacco prevention, it seems we can ill afford to become complacent or distracted.

West Central Tribune file photo

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