Smoking: A Kid's Disease?

Cigarettes are "not a safe product" and are a threat to young people, said the head of the Food and Drug Administration (FDA) yesterday in a speech at the Medical School.

Dr. David A. Kessler, commissioner of the FDA, talked about nicotine addiction as a kids' disease in the second annual Zinberg Memorial Lecture.

"A person who hasn't started smoking by 19, 20 or 21 is unlikely to ever become a smoker," Kessler told an audience of 100. "Every day, another 3,000 teens begin smoking...and are the prime source of new customers for tobacco companies."

Smoking should not be thought of as only an adult problem, according to Kessler.

"It is easy to think of smoking as an adult problem. Adults are the ones who die," Kessler said. "This is like entering the theater in the third act."

Kessler describes smoking addiction not as a decision of an adult, but the entrapment of a child.

"A child learns the ritual, born out of curiosity, a desire to rebel and to be accepted," Kessler said. "The ritual tragically lasts a lifetime, and may shorten it."

"One-third to one-half of adolescents who try a few soon become regular smokers," Kessler said. "Ninety percent of those who smoke begin as teens."

Kessler, a 1979 graduate of the Medical School, criticized initiatives of tobacco companies in the United States and Canada to identify and attract young smokers through advertising.

"Marlboro, Camel, and Newport advertise the most and are most consumed by adolescents," Kessler said. "In 1992, the tobacco industry spent $5.2 billion dollars on advertising...falling second only to the auto industry in the most dollars spent on advertising."

Kessler told the audience that most smokers keep the brand they first try.

"There is a great deal of brand loyalty in the young years of smoking," Kessler said.

In recent years, the percentage of high school seniors and college first-years who smoke increased, according to Kessler.

"From 1992 to 1993, the percentage of high school seniors went from 17.2 to 19 percent, and college freshmen went from 9.2 to 12.5 percent," Kessler said. "A casual decision at a young age can lead to addiction, disease and premature death."

"There are more deaths from smoking annually than from AIDS, car accidents, alcohol, illegal drugs, fires and suicides combined," Kessler told the audience of doctors and students. "All of the advertising is chillingly effective."

Kessler also said that young children know tobacco brands even if they don't smoke.

"Kids as young as three to six years old recognize Joe Camel as easily as Ronald McDonald," Kessler said.

Although the FDA is looking at its role in controlling tobacco, Kessler does not suggest a ban.

"The FDA has been looking at tobacco as a drug for the past year. Nicotine is an addictive substance, and the marketplace is sustained by addiction," Kessler said. "A ban is just not feasible."

The FDA is also concerned about the ease with which teens can obtain cigarettes.

"In 1990, the National Cancer Institute found that eight of 10 ninth graders said it would be easy to buy their own cigarettes," Kessler said. "It has been estimated that 255 million packs are sold illegally to minors every year."

Kessler said that people are generally impatient when it comes to answers to health questions, but the hooked smokers of today may not be the best focal point.

"To succeed, we must fix our gaze beyond today's adults," Kessler said. "Nicotine addiction could go the way of smallpox or polio."

Kessler did point to an unusual trend in the tendency of one group of young people to smoke.

"Over the past few years, the number of African-American high school seniors who smoke has plummeted from 23 to five percent, with white students stagnating at 20 percent," Kessler said. "In a National Cancer Institute study, it was found that African American students did not think it was `cool to smoke."