U.S. War on Smoking Faltering, Studies Show

The nation’s war on smoking is faltering because, while overall tobacco use is dropping, the number of people who quit is being largely offset by the recruitment of 3,000 new smokers per day--most of them young.

And as this is happening, a series of government research reports to be published today finds, the demographics of smoking are undergoing vast change and, by the turn of the century, tobacco use is expected to become overwhelmingly a habit of the poorly educated.

By the year 2000, researchers at the U.S. Office on Smoking and Health predict, at least 30% of people with less than a high school education will be smokers, but less than 10% of college graduates will be. Confounding history, as well, by the turn of the century proportionately more women will smoke than men.

In all, said Dr. George Lundberg, editor of the Journal of the American Medical Assn., which is publishing the new research reports today in its fourth special issue devoted to smoking research, the prospect of achieving the goal of making the United States a smoke-free society by the year 2000 “is virtually hopeless.”

The government research also concludes that nearer-term objectives in the smoking war are in even greater danger of not being met. One government study finds that by 1990 the proportion of pregnant women who smoke will be 70% of the rate for women in general. A key goal of government smoking policy experts had been to cut that rate to 50%

The report on smoking rates and pregnancy, by the government’s Centers for Disease Control in Atlanta, found that young, unmarried white women who are pregnant are 40% more likely to smoke than their contemporaries who are not pregnant.

Overall, at the turn of the century, 22% of Americans will use tobacco--20% of all men, 23% of all women, 25% of blacks and 21% of whites. In 1990, researchers predict, 29% of men and 26% of women will smoke, down from the 32.7% of men and 28.3% of women who did so in 1985.

And even with overall smoking rates dropping, concludes an analysis by the federal government’s Office on Smoking and Health of smoking trends by the year 2000, tobacco marketing success among young people means that there are still 3,000 new smokers being recruited every day nationwide.

“I had hoped that the accelerated rate of cessation of tobacco use that we are seeing among educated people would not be countered by new smokers to the extent that it apparently will be,” Lundberg said. “And that’s discouraging.”

The special issue of the medical journal appears days before release next Wednesday of the annual report on smoking and health by U.S. Surgeon General C. Everett Koop. The new Koop report comes 25 years to the day after the first federal anti-smoking initiative by Surgeon General Luther Terry in 1964.

But in a development that appeared to reflect concern about being upstaged, Koop ordered his top smoking-policy aides, including Dr. Ronald Davis, head of the Office on Smoking and Health, to refuse to discuss three major new studies of smoking trends nationwide. Davis is one of the principal authors of four of the studies being published today.

The order, said Koop’s chief spokesman and Davis himself, was issued in an attempt to minimize the public relations damage by the special issue of the medical journal to the imminent release of Koop’s own document.

Warns on Complacency

But in an editorial in the medical journal, Koop warned against complacency among anti-smoking activists, concluding that despite steady decline in smoking rates nationwide, leaders of the movement against tobacco use “should rejoice in these accomplishments--but only for a moment.

“When we remind ourselves that 50 million Americans continue to smoke, and that more than 300,000 continue to die each year of smoking-related disease, we remember why we can never let ourselves become complacent.

“Despite declining sales, the cigarette industry remains one of the most profitable and powerful businesses in America. It uses its vast economic strength to defend the promotion, sale and use of tobacco and to punish those who stand in its way.”

The three major government studies and a variety of other research papers released today apparently closely parallel at least some of the top conclusions in Koop’s impending annual smoking report. Among the findings:

- Smoking rates for all sex and race groups dropped between 1974 and 1985, but the rate of decline was greater for men (33.5%) than for women (27.6%). The effect of quit-smoking programs, however, was tempered by stubbornly high smoking-initiation rates. Rates at which people aged 20 to 24 took up the tobacco habit dropped markedly for men, from 44.8% to 33.4%, but remained nearly static for women--actually increasing from 33.4% to 34.6%. Among young women in 1985, smoking rates increased to an all-time high of 44.4%. The study was conducted by the Office on Smoking and Health.

“It appears as though we have been somewhat successful in convincing Americans to stop smoking,” said Dr. Michael Fiore, a former Office on Smoking and Health researcher involved in the new reports. “Since the early 1980s, almost 2 million have quit per year.”

But, said Fiore, who is now on the faculty at the University of Wisconsin in Madison, “this success has been offset by approximately 1 million new young people per year who have continued to start smoking.”

- The latest trends in smoking indicate that gender has yielded its position of dominance as a predictor of smoking behavior to the influence of educational status. Between 1974 and 1985, smoking prevalence among college graduates dropped to 18.4% from 28.5%. But the rate for people with less than a high school education was nearly double that figure--34.2%--down only 2% from 11 years earlier.

The government research found that smoking by less-educated women dropped suddenly in 1987, but, overall, the report concluded that strategies to promote smoking cessation must be readjusted to take the growing education gap into account.

- Based on the higher-than-expected smoking rates among pregnant women, government scientists conclude that overall prevention strategies among women of childbearing age have failed so decisively that government goals for 1990 are doomed. Smoking by pregnant women has been linked to a variety of birth defects and complications.

- In a study in Santa Clara County, Stanford University researchers found that a communitywide media campaign, combined with organized programs to persuade retail stores to curtail tobacco sales to 14- to 16-year-olds, can have a surprisingly large effect on the ease with which teen-agers can buy cigarettes. The research, based in Palo Alto, found over-the-counter illegal cigarette sales were reduced by 39% in the program. Vending machine sales were unaffected.

- Anti-smoking warnings in billboard advertising are in print too small to be read easily from a passing car. The warning was also judged ineffective in magazine advertising read by minors who, in a study of eye tracking behavior, found that teen-agers overlooked the warning messages in nearly 44% of all cases.