Teen-Agers Face Special Smoking Risk, Report Warns : Health: Surgeon general says tobacco use among youths is still prevalent. The industry’s advertising campaigns are singled out for blame.

Cigarette smoking--of all addictive behaviors--is the one most likely to take hold during adolescence and almost all adult smokers took their first drag before they were graduated from high school, the surgeon general’s annual report on smoking said Thursday.

Surgeon General Joycelyn Elders unveiled the report with a warning to the nation’s young people: “Tobacco addicts and it kills.”

“We can no longer discuss smoking as an adult habit--because today, tobacco use, without question, is an adolescent tragedy,” she added at a news conference.

The report, which focused on cigarette smoking and youth, is part of a series of documents released since the landmark 1964 report that first established cigarette smoking as a significant danger to health.

Cigarette smoking is a major contributor to heart disease--the leading killer of adults in the United States--and stroke, as well as a chief cause of certain cancers and respiratory ailments. Federal health officials blame smoking for an estimated 434,000 deaths a year.

Although tobacco use declined among high school seniors in the 1970s, it remained steady in the 1980s and is now on the rise again at all grade levels, according to a survey released recently by the federal government. Cigarettes and alcohol remain the most widely abused substances among the nation’s youth, the survey said.

Now, more than 3 million adolescents smoke cigarettes and more than 1 million adolescent males use smokeless tobacco, the surgeon general’s report said.

“Despite three decades of explicit health warnings, large numbers of young people continue to take up tobacco,” the report said. One out of every three adolescents in the United States uses tobacco by age 18, it added.

The report blamed the tobacco industry’s $4-billion-a-year cigarette advertising and promotional campaign for contributing to teen-age smoking, but said that disincentives to smoking--such as tobacco tax increases and school-based tobacco-use prevention programs--are effective.

Advertising “appears to increase young people’s risk of smoking by affecting their perceptions of the pervasiveness, image and function of smoking,” the report said.

Since cigarette ads were banned from the broadcast media, “there has been a continuing shift from advertising to promotion,” such as the sponsoring of sports events, the report said.

“Clearly, young people are being indoctrinated with tobacco promotion at a susceptible time in their lives,” it said. “Young people face enormous pressures to smoke.”

School-based programs that identify social influences on smoking and provide skills to resist those influences have demonstrated “consistent and significant reductions in adolescent smoking prevalence,” the report said.

Also, “a crucial element of prevention is access,” the report added. “Adolescents should not be able to purchase tobacco products in their communities.”

Elders took special aim at the R.J. Reynolds Tobacco Co. for its controversial “Joe Camel” ads, and she challenged the Federal Trade Commission to act on petitions against the advertising campaign.

Peggy Carter, a spokeswoman for R.J. Reynolds, said a recent study done for the company indicated that Joe Camel was not influencing the nation’s children to smoke.

“It showed that Joe Camel is not the most memorable advertising character with youth--and, in fact, the strong negative reaction to the product he represents suggests that the campaign is not causing youth to start smoking,” she said.

While condemning cigarette advertising for influencing young people to smoke, Elders did not call for a total advertising ban. However, she said “we shouldn’t advertise something we know to be a poison and a killer.”

She also called for higher cigarette taxes, a move already proposed by President Clinton to help finance his health care reform plan.

Officials from the tobacco industry said they agreed with much of the report, including its basic message--that young people should be prevented from smoking--but took issue with some of the specifics, particularly the charge that advertising and promotion are largely responsible for the problem.

“There’s a lot of room for agreement,” said Brennan Dawson, a spokeswoman for the Tobacco Institute. “Industry has been a leader in developing and marketing (materials) for parents and working with the school systems to discourage young people from smoking.”

Nevertheless, she called it “misguided” to attack advertising and promotion as the main villains in enticing young people to smoke.

“Advertising is not the factor that gets young people to smoke,” she said. “The (report) talks about ads creating a positive environment for smoking. The surveys all show that young people are very aware of the risks.”

The American Cancer Society, the American Heart Assn. and the American Lung Assn. issued a joint statement supporting the report’s conclusions and Elders’ comments, saying: “We need to reduce conditions that contribute to tobacco use and help young people turn their backs on tobacco.”

In conjunction with the report, the Department of Health and Human Services also released a new surgeon general’s report for children. The magazine-style document is geared for students in sixth grade--where smoking often starts.