Debate and Issues Archive

draft settlement

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 require:

(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 their lives.

(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 effectiveness.

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.