Under Fire: Women and Smoking : Health: More young women are smoking and cigarette companies are pursuing the gain with ads that show smokers as slim, sexy and attractive. The ads have critics fuming.

Barbara Berman was driving down Westwood Boulevard when her 12-year-old daughter began admiring the clothing worn by a slim model peering from a roadside billboard. It’s a lovely sweater, Berman agreed with her daughter. But did she notice that the billboard was a cigarette advertisement?

“What struck me was that she noticed the clothing first,” says Berman, a sociologist who studies smoking among women. “She noticed it was a cigarette advertisement later.”

Experts in smoking control admit they are having a hard time countering advertisements that depict young, female smokers as glamorous and thin. According to the U.S. Office on Smoking and Health, the nation’s ardent anti-smoking campaign has failed so decisively among young women that this group will soon become the predominant category of U.S. smokers.

Overall, smoking rates have dropped from 40% in 1965 to 29% in 1987. But the success story belongs largely to adult smokers, especially white men. Among women from early adolescence through age 24, smoking rates have barely dipped, and some studies suggest women are smoking more heavily than ever.

“It has been our least successful area,” says Ronald Arias, a spokesman for the Los Angeles chapter of the American Lung Assn., which directs one of the nation’s largest budgets devoted to smoking prevention and cessation programs. “This is the group that continues to smoke, even during pregnancy.”

Among high school seniors, more females smoke than males, reports the Office on Smoking and Health. College surveys show that 18% of women are smokers, compared to 10% of men. A 1989 report by the U.S. Surgeon General found that the rates at which people ages 20 to 24 took up smoking dropped for men in the mid-1980s, but increased for women.

The billboards of attractive female smokers are painful reminders that tobacco companies view young women as their best customers, says Berman, a research analyst with the division of cancer control at UCLA’s Jonsson Comprehensive Cancer Center.

“It’s not reassuring,” she says. “While we’re struggling with the anti-smoking message, the tobacco advertising industry is scrambling just as fast.”

Seductive cigarette ads on billboards and in women’s magazines are highly effective in reaching women, especially young girls, anti-smoking experts say. Statistics show that most smokers begin the habit before age 19. An estimated 60% start by age 14.

“We think young women are more vulnerable to advertising,” says Michele Bloch, director of the Washington-based advocacy group Women vs. Smoking Network. “The ads appeal to autonomy and independence and thinness. Look at how all the brands are named: slim, thin, light, long.

“Teen-age girls are particularly weight-conscious. Many girls use smoking as a weight-control mechanism. It’s probably one of the biggest things that attracts young girls and keeps them smoking as they grow into adulthood.”

Smoking-control experts say they are revamping their education programs for women to address issues that influence smoking among women, such as weight control and coping with stress. The state of California last week announced a new advertising program to counter the image of cigarettes as “cool.”

Traditionally, education efforts directed toward youths have emphasized health risks associated with smoking. It is well known that smoking increases the risk of heart attack, stroke, lung diseases and cancer. In 1987, for the first time, more women died of lung cancer than breast cancer, the American Cancer Society reports. Women bear the additional risk of harming their fetus if they smoke during pregnancy.

Yet, young girls, like young boys, appear oblivious to the health consequences of smoking, Berman says.

“Smoking has a lot to do with peer pressure,” she says, adding that “75% of all youngsters who have that first cigarette have it with others who smoke.”

Peer pressure may weigh more heavily on young women. Studies show that young girls are more likely than boys to mimic behaviors of their more popular peers; more boys also participate in athletics where smoking is discouraged by coaches, studies suggest.

“It has taken us time to realize how you keep kids from smoking,” Bloch admits. “One of the things that doesn’t work with smoking is telling them that, 20 years down the road, they’ll have lung cancer.”

But countering effective cigarette advertising remains a big factor in reversing smoking trends among women, Bloch says.

“Young girls are being bombarded by advertising,” Bloch says. “The tobacco industry knows who their customers are. They’re women more than men and uneducated people more than educated people.”

Women vs. Smoking Network is leading a vigorous protest against Dakota, a new cigarette marketed by the R.J. Reynolds Tobacco Co. According to the manufacturer’s marketing plans, obtained by Bloch’s group in February, Dakota is tailored to young, uneducated white women, ages 18 to 24, whom it calls “virile females.” The marketing plans describe the potential Dakota smoker as a woman who enjoyes the TV show “Roseanne” and attending tractor-pulls with her boyfriend.

Reynolds officials say the cigarette is not aimed solely at women. But Bloch maintains the intent of the ad plan is clear and calls Reynolds’ targeting of a vulnerable subgroup “pitiful.”

Tobacco industry officials disagree that ads attract young women to smoke. According to Thomas Lauria, a spokesman for the Tobacco Institute, an industry group, the ads are meant to persuade committed smokers to switch brands. “Our research indicates that peer pressure and parental and sibling influence have the most effect,” in persuading girls to smoke, Lauria says.

But according to anti-smoking forces, even healthy, nonsmoking tennis players can influence young women to smoke.

Led by U.S. Secretary of Health and Human Services Louis Sullivan, a coalition of women’s groups and health organizations recently called on the Philip Morris Co., maker of Virginia Slims, to withdraw as a major sponsor of the Women’s Tennis Assn.

While the cigarette company has done much to promote women’s tennis, its sponsorship also promotes smoking, says Dr. Kenneth W. Kizer, director of the California Department of Health Services. Last week, Kizer announced that the state’s new anti-smoking media campaign, the largest of its kind, will focus on young, pregnant women.

“You don’t necessarily think about smoking, but it’s subliminal,” Kizer says. “ ‘Smoking is OK. If they’re doing it here at the tennis tournament, it must be pretty cool.’ ”

And, says Bloch: “The tobacco industry wouldn’t be sponsoring it if they didn’t think it was having an effect. . . . They’re (industry) trying to promote that smoking is a vigorous, healthy activity.”

In schools, anti-smoking educational programs also should try to erode the stylish image that young people associate with smoking, say authors of a recently released RAND Corp. survey, published in the journal Science.

According to the RAND study, one of the most thorough of its kind, lessons concentrating on the unpleasant aspects of smoking, such as bad breath and yellowed teeth, were effective among children ages 12 to 14.

But, the study found, anti-smoking programs for youngsters already smoking by the time they enter junior high were ineffective. “We need to get to them earlier,” Bloch says. “And we need to get to the kids more likely to smoke--kids who are not likely to become high school seniors.”

Preventing women from smoking should be the primary focus of health and women’s groups, says Dr. Ellen R. Gritz, director of the division of cancer control at UCLA’s Jonsson Comprehensive Cancer Center. Gritz, a renowned researcher of smoking trends among women, says she has appealed to women’s groups for years to campaign against smoking.

“I’ve been waiting to see the leading women’s organizations say that smoking is a major problem for women and be willing to devote their agenda and voices to it,” Gritz says. “Mostly, they don’t say anything.”

The political clout wielded by leading women’s groups is needed to protest the marketing of cigarettes to young women, Bloch says. For instance, she notes, when R.J. Reynolds announced plans to test-market Uptown, a cigarette targeted to black men, the product was quickly crushed by opposition from a health advocacy group, the National Black Leadership Initiative on Cancer.

“When Uptown came along, the National Black Leadership Initiative on Cancer was already there. They mobilized and got Uptown out,” Bloch says. “Our goal is to organize women’s groups so we can react in that kind of fashion. We don’t have that now, but that is our goal.”

Smoking Takes Its Toll on Women

These are the potential health problems associated with smoking in women:

* Cancer of lung, breast, bladder, pancreas, pharynx, larynx, esophagus, cervix, mouth.

* Lung diseases such as emphysema.

* Obstetrical woes such as stillbirth, miscarriage, low birth-weight babies and babies who die from Sudden Infant Death Syndrome.

* Doubled risk of heart disease. (Rate is even higher for smokers using oral contraceptives.)

* Stroke.

SOURCE: U.S. Department of Health and Human Services