Florida is accomplishing what many health experts once considered nearly impossible: It is making smoking an "uncool" activity among teenagers.
That is, the state is persuading teens not only that it is unhealthy to light up a cigarette but that kids are being manipulated by the tobacco industry.
It is a message served up in irreverent, in-your-face television advertisements designed and approved by Florida teens and intended entirely for a teenage audience. They've been running for two years on Florida TV stations as part of a wide-ranging and aggressive anti-tobacco campaign that is proving far more successful than anyone predicted.
A recent statewide survey shows that, within the past two years, smoking declined by 54 percent among middle school students and by 24 percent among high school students. That translates to roughly 80,000 students who are not smoking today.
"They are the most dramatic results we've seen in youth smoking from any of the comprehensive programs we've seen implemented," says Danny McGoldrick, director of research at the Campaign for Tobacco-Free Kids in Washington, D.C. "They provide astounding evidence that comprehensive, well-funded antitobacco programs work."
Indeed, Florida is setting the standard for the nation in how to conduct a results-oriented antitobacco campaign. It is a breakthrough that could spur other states flush with cash from the multibillion-dollar national tobacco settlement.
Until now, that hasn't happened. Many states have chosen to use tobacco-settlement money as a source of general revenue rather than as a means to prevent children from becoming addicted to nicotine.
Other states have also seen results from their antismoking campaigns: In Massachusetts, which began its antitobacco program in 1993, a survey released last week recorded a 15 percent decline in smoking by high school students since 1995. In California, the effort begun in 1990 has resulted in a reduction of adult smokers from 27 percent of the population down to 18 percent.
But many other states are counting on the efforts of the American Legacy Foundation. The foundation was set up last year in Washington to wage a nationwide antitobacco campaign. It is funded with money pooled from the settlement of state tobacco lawsuits.
"The only way we will succeed as a nation is for the states to put at least some of the tobacco-settlement dollars into their own tobacco-prevention efforts," says spokesman Bill Furmanski. "We are here to supplement those programs, not replace them."
The Florida program includes anti-tobacco education programs starting in grade school, teen-run partnerships at the county level and a tough enforcement effort in which kids caught with tobacco face losing their driver's license. But the best-known aspect of Florida's program is its gritty TV ads. An ad on the air in Florida features a group of tobacco-industry officials at the hospital bedside of a man who appears to be dying. The executives are thanking the patient for his longtime use of their products. As they leave, the executives wonder how they will replace their dying customers. Then they encounter a teen sitting in the hospital hallway.
What's interesting about such ads is teens are telling other kids they are the target of an industry that cares nothing about their well-being. It is a message that is apparently taking hold, experts say.
And that has the tobacco industry ready to fight back. Last month, when the Legacy Foundation unveiled its new national television advertising campaign, industry lawyers successfully blocked two of the four proposed commercials on grounds that they were unfair attacks on the industry. Both were patterned on the Florida ads.
One of the ads features a young woman carrying a suitcase labeled "lie detector" as she enters the offices of a major tobacco company. When she asks to speak to a marketing director about whether nicotine is addictive, she is promptly escorted out of the building.
The industry was able to block the ads by citing a little-noticed clause written into the Legacy Foundation's charter by tobacco-industry lawyers. It bars the group from launching any direct attacks that tend to "vilify" tobacco companies and its executives. In effect, it provides legal leverage to prevent the national campaign from replicating a key part of Florida's successful campaign.
Many anti-tobacco activists question how they can wage an effective anti-tobacco campaign without somehow vilifying the tobacco industry and its executives.
Legacy Foundation officials say that their decision not to run the two ads was a tactical maneuver and does not signal a surrender. Furmanski stresses that none of the states is bound by an anti-vilification clause, and that all states are free to replicate Florida's aggressive campaign if they choose.
Debby Bodenstine, director of Florida's Office of Tobacco Control, says Florida's success is attracting some interest from other states, including Missouri, Kansas and Iowa.
But even Florida may not be immune from a budget battle over how best to spend settlement money. Some lawmakers last year discussed ending funding to Florida's anti-tobacco effort because they said it was unproven. State officials say such a drastic move is unlikely after the recent survey.
Nonetheless, the program is slated for budget cuts. The Florida campaign spent $55 million last year. State officials are planning to ask for roughly $39 million for the coming year — a 29 percent reduction.
Warren Richey, The Christian Science Monitor
Copyright © March 17, 2000, The Christian Science Monitor. All rights reserved.