SATCHER: Save the Kids, Fight Tobacco
The Washington Post
Date: May 25, 1999
Tuesday, May 25, 1999; Page A15
The single most promising public health intervention today is not
the development of a new drug but the opportunity to invest part
of the recent $246 billion settlement with the tobacco companies
into public health and proven programs that would prevent our
nation's children from smoking.
Those lawsuits were about health -- the health of generations of
Americans, living and dead, young and old. The success of the
tobacco settlement should be measured by how it improves the
public health. I believe a great achievement is possible if Congress
and the states work together to commit some of these resources
to effective programs that will help prevent millions of our children
from becoming victims of tobacco-related diseases.
The money from the settlement offers our country an opportunity
similar in some respects to that of the polio vaccine in the 1950s.
While polio was for decades the silent killer of children, today
tobacco quietly addicts thousands of children each day to a drug
that will frequently lead to awful health consequences later in life.
The polio vaccine saved thousands of lives because as a nation
we invested in its discovery and ensured that Americans would
benefit from its use. We have now reached a point in our knowledge
of public health where an investment in comprehensive state
tobacco control programs could achieve similar results.
The facts speak for themselves. Tobacco represents the single
most preventable cause of premature death and preventable illness.
More than 425,000 people die each year from smoking-related
illnesses. Each day, 3,000 young people become regular smokers.
One-half of them will be addicted to tobacco before they are legally
old enough to buy cigarettes, and one-third will eventually die from
smoking-related illness. More than 45 million Americans already
are addicted, and the industry continues to spend billions of dollars
each year promoting the sale of tobacco.
These facts reveal nothing less than a public health care crisis,
which requires a focused public health effort to reduce youth
smoking. Last year's settlement between the states and the
tobacco industry was a step in the right direction, but clearly more
needs to be done. With money in hand, states now have the
necessary resources to launch a comprehensive, effective public
health program against tobacco. Successful models of statewide
programs exist in Massachusetts, California and other states; we
know what programs work. Effective tobacco control programs
(1) Public education. Messages that promote smoking must be
countered with creative ads that run in prime time and are designed
to educate as well as motivate.
(2) Community-based programs. Community involvement is
essential to reducing tobacco use. Public-private partnerships
can be quite effective.
(3) Treatment for tobacco addiction. Effective cessation services
should be available to anyone who needs help quitting. These
programs can help millions of tobacco users quit for the rest of
(4) School-based programs. Our schools need programs that teach
children the dangers of tobacco but also impart the life skills, refusal
skills and media literacy that help them resist peer pressure and
powerful tobacco advertising.
(5) Enforcement, evaluation, surveillance. State laws prohibiting
tobacco sales to children need to be taken seriously and vigorously
enforced. Kids should not have access to cigarettes. Evaluation
and surveillance are essential to monitor and improve program
In addition, experts agree that the single most important step we
can take to reduce youth smoking is to significantly raise the price
of cigarettes. The president has proposed doing so by 55 cents
per pack. States should also recognize the powerful effect that
price has on our children's health.
There are a number of deserving programs that seek a portion of
the settlement funds. But I would suggest that there can be no
greater priority to public health, community health or family health
in this country than ensuring a robust and comprehensive tobacco
control program in every state.
We have not had a case of Y-virus polio in the United States since
1979, and we are moving rapidly toward global eradication. If we
work together and make a commitment to tobacco control, one day
we will be able to say the same thing about smoking-related diseases.
The writer is surgeon general of the United States.