The following commentary by Gregory A. Hand, special assistant to the vice president for health sciences, and Linda A. Alexander, associate dean for academic affairs in the School of Public Health, appeared in the Charleston Gazette-Mail Oct. 23.
West Virginia made a significant step forward in population health earlier this year by increasing the tax on tobacco products. Raising taxes on cigarettes and other smoking-related products has proven to be the most cost effective way to reduce smoking — particularly among young people.
But even the increase in the cost of tobacco won’t be enough to move West Virginia out of the top spot on the list of states with the highest rates of smoking.
We need to interrupt the cycle of nicotine addiction that perpetuates smoking from one generation to the next!
The good news is that this cycle can be broken. As with any addiction, it makes sense that not beginning to smoke is easier than stopping once an individual becomes dependent on nicotine.
If we focus on prevention of young people beginning to smoke, we can see far quicker changes than we can by focusing on current smokers. The proven interventions that have been shown to reduce smoking among young people can reduce the rates of smoking among youth relatively quickly since nicotine dependence is not a factor like it is for long-term smokers.
And while studies indicate that there is a 10 to 15 percent reduction in youth smoking for every increase of 10 cents in the price of a pack of cigarettes, price doesn’t seem to have much effect on the initial experimentation with tobacco. So other interventions are needed in conjunction with increasing the price of cigarettes if West Virginia wants to be known for low rates of smoking.
These interventions must, together, provide a clear and consistent message that adolescent smoking isn’t normal and isn’t acceptable.
The progression from experimenting with smoking to smoking occasionally to becoming a regular smoker takes time, often years. Most smokers have begun the process by age 18 and it is very rare that a smoker will begin after the age of 24. This means that there are multiple opportunities to prevent a child from becoming a regular smoker.
Adolescent smokers are creative in finding outlets for cigarette purchases – stores that sell to minors, paying older teens for cigarettes, and stealing cigarettes from parents and other adults. But experience in West Virginia and elsewhere has shown that five kinds of interventions are effective in reducing the rate of childhood smoking:
- Increasing the price of smoking-related products and limiting purchases.
- Mass media advertising on the dangers of smoking — especially pictorial warning labels that have proven to be effective in adolescent smokers and teens considering smoking.
- Smoke-free policies that eliminate the threat of second-hand smoke in public places and work places.
- Educational programs in schools to promote healthy choices.
- Restrictions on tobacco marketing, especially marketing that impacts kids.
To be most effective, these interventions should be used in combination, to create a comprehensive program that denormalizes smoking behavior across the community.
West Virginia continues to have a high rate of smoking among all age groups and pregnant women. But a great starting point for the state is a continued focus on our future — raising taxes begins the cultural shift we are looking for. And the culture can change the fastest among adolescents who are not yet addicted to nicotine. The recent increase in the tax on tobacco is part of regaining our children’s smoke-free future. Many communities, school, and programs have programs to support this forward movement.
Changing the culture of smoking requires interventions that include antismoking advertising and programs to counter pro-tobacco influences, minimize exposure to second hand smoke and reduce the availability of tobacco to minors. What role can you play in making sure children inherit a smoke-free West Virginia?