Tobacco War Will Target Minorities : Health: Orange County expects to start a $2.9-million program in June to discourage smoking in the ethnic populations that are now under siege by an industry blitz.

As a young woman in Cambodia, Kol Yon started chewing a concoction of betel nut, lime juice and thick clumps of tobacco because she wanted the scarlet lips and black teeth her culture considered beautiful.

Now Kol Yon, 78, says she chews for the sensation on her lips and the nicotine high. She picks out her ingredients from dozens of products on sale at the Asian market near her apartment in downtown Santa Ana.

She has never heard, she said, about cancer.

Not far from where Kol Yon and her friends congregate to chew together at an apartment that doubles as a Buddhist temple, a Spanish-language billboard on 17th Street adorned with a cartoon camel and a flashy convertible promises young Latinos that a cigarette is suave, or smooth.

Both examples are drawn from the newest front in the state’s $220-million war on tobacco: Orange County’s effort to reach minorities who have brought age-old tobacco customs with them to the United States or--far more disturbing to health officials--who are being attracted to smoking for the first time.

“They (tobacco companies) need to find new markets because smoking kills off a lot of their customers, and a lot of others are quitting,” said Dr. Hildy Meyers, director of the county’s new anti-tobacco campaign.

“It’s kind of obvious where they’re going. A lot of promotional and billboard advertising is aimed at minorities.”

The anti-tobacco campaign will be paid for with the county’s share of the Proposition 99 statewide tax, which added 25 cents to a pack of cigarettes as of January, 1989, and is expected to net Orange County $2.9 million over the next two years.

The money will be used to build a network of educational and counseling services that will work through schools, physicians, clinics and neighborhood community groups to discourage tobacco use. Health officials are putting the final touches on a proposal expected to be presented to the Board of Supervisors in May.

The program, the first comprehensive anti-tobacco effort ever undertaken by the county, is set to get under way in June.

The theme of the public awareness program echoes that of the state’s sometimes controversial anti-tobacco billboard and broadcast advertising blitz. Since it was unveiled two weeks ago, several television stations have refused to run some of the ads, saying they are unfair to the tobacco industry.

Like the state, the county will target minorities, who health officials say are being exploited by cigarette advertising. Those considered most vulnerable, according to the county’s target list, are blacks, Latinos, Asians and teen-agers. The county campaign will also focus on those who face the greatest risk from tobacco smoke: women and teen-age girls who are pregnant.

Among the trends most disturbing to health officials is the apparent increase in cigarette use among female members of minority groups. Smoking rates among young female Asian and Latino immigrants, for example, have tended to be lower than the rates among young Anglo females born in the United States. But as these young immigrant women have become more westernized, their smoking rates have climbed, health officials said.

These young women are among the most likely to be attracted by cigarette ads that stress sophistication and liberation, officials said.

Young male Latinos, whose smoking rates are far higher than their Anglo counterparts, are also increasingly targeted by cigarette advertising, health officials said.

Meyers cites a 1987 study by a private health research group that reported the tobacco industry spent $490.7 million on advertising aimed at Latinos living in the United States, more than a 20% increase over the year before.

“The cigarette marketing people are very clever so the health department people need to be,” explains Nampet Panchipant-M, director of immigrant services for the county health department and one of the coordinators of the anti-smoking campaign.

As part of their counterattack, county officials hope to set up a 24-hour multilingual hot line to offer advice and counseling referrals to smokers or relatives of those who smoke within minority populations.

The dangers of secondary smoke, especially to pregnant women, will be given heavy emphasis in the county campaign. Pregnant women who call the hot line, for example, might be offered advice on reducing their exposure to cigarettes even if they don’t smoke, but live or work closely with a smoker.

County officials are quick to acknowledge, however, that they must place their greatest emphasis on work outside their offices and within the community. The addition of three “bilingual and bicultural” health educators was recommended in an earlier report to the Board of Supervisors to help bridge both language and cultural gaps.

“We’re going to have to go where the target population is,” said Panchipant-M, herself a native of Thailand. “If we say you can come to our clinic and we’ll help you, they’re not going to come. . . .”

Health department officials say they will borrow a page of the tobacco industry’s advertising manual by trying to come up with themes that target specific ethnic groups.

As an example, officials point to a Spanish-language brochure produced by the U.S. Department of Health and Human Services, which they say capitalizes on the Latino culture’s traditionally close-knit families. Rather than stressing only the benefits to an individual’s health, the brochure urges smokers to quit for the sake of their loved ones.

On the other hand, messages aimed at Asian smokers, Panchipant-M said, must be carefully worded to politely suggest that they consider quitting while avoiding a more direct message that would be considered culturally rude.

In any case, reaching the diverse Asian community with an effective anti-tobacco campaign will be a formidable task.

Simply put, Panchipant M said, there is no “unified infrastructure” for communicating to the 200,000 Asian-born residents of Orange County. Officials must shape a message for 17 different population groups, each with distinct cultures and languages or dialects.

Moreover, some of those population groups--the Hmong mountain tribes of Laos recruited by the United States to fight during the Vietnam War, for example--have no tradition of a written language. Many other immigrants from war-torn rural areas of Southeast Asia have no formal education and have never learned to read or write.

For those groups, county officials said they will have to rely heavily on visual messages and direct person-to-person contact. But beyond literacy problems lies a more fundamental barrier: the lack of even the most rudimentary understanding of health issues.

TROUBLESOME TARGET

* The state’s $220-million war on tobacco will direct $2.9 million into Orange County.

* A main target will be the 200,000 Asian-born residents here, but officials must shape a message for 17 groups, each with distinct languages.

* Some messages must be worded to politely suggest that they quit, while avoiding a more direct message that would be taken as culturally rude.

* As part of their attack, county officials hope to set up a 24-hour multilingual hot line to offer advice to minority-group smokers.