Thursday, August 16, 2001

State battles
Big Tobacco over
teens’ attitudes

The issue: To entice young people to
smoke, tobacco companies are defying
advertising guidelines in their
settlement with states.

EFFORTS to discourage Hawaii's children from smoking are producing favorable results, despite tobacco companies' defiance of the terms of their 1998 settlement with the states. Although the companies continue to advertise in magazines reaching millions of young people, the number of teens in Hawaii who smoke seems to be on the decline. The state should continue its aggressive efforts and consider joining a lawsuit to force Big Tobacco to abide by the settlement.

Results of the 2000 Hawaii and 1999 National Youth Tobacco Survey show that Hawaii's teens who have smoked at least once dropped from 68.8 percent in 1995 to 63.3 percent last year. The comparable national average among high school students in 1999 was 63.5 percent.

The figures are important because 80 percent of today's adult smokers took up the habit when they were under 18. Every day, nearly 3,000 young people begin smoking regularly, according to the National Centers for Disease Control and Prevention.

Advertising is necessary for tobacco companies to capture a youthful market to replace the 430,000 adults who die every year from tobacco-related diseases. More than a quarter of the nation's high school students are smokers.

The ads play a critical role in determining children's attitudes toward smoking. Unfortunately, the Hawaii survey shows that 36.9 percent of high school students who smoke think it helps them gain friends, compared with 26.6 percent nationally. Even 12.8 percent of those who never smoked think cigarettes make their classmates look cool or help them fit in, compared with 6.9 percent nationally.

Tobacco companies recognize that importance. They buy advertisements in magazines such as Rolling Stone, People, Entertainment Weekly, Sports Illustrated and TV Guide, all of which have large readerships by young people that should place them off-limits to cigarette advertising. Guidelines that were part of the settlement say tobacco companies should not advertise in magazines if more than 15 percent of a magazine's readers, or more than two million readers of the magazine, are under 18.

While Philip Morris, the largest tobacco company, has followed the guidelines, the other major cigarette producers -- R.J. Reynolds, Brown & Williamson and Lorillard -- say the guidelines are not legally binding. That is absurd, and California Attorney General Bill Lockyer is disputing the companies' defiance in court, joined by attorneys general of Oregon, New York, Ohio and Washington.

Lanai takes a big leap
toward dental health

The issue: The island's private water
company opens its taps to fluoridation.

Dr. Noa Emmett Aluli of Molokai says it's easy to recognize people who grew up in Maunaloa during the 1960s "because of their smiles. They've got healthy and attractive teeth." That's because between 1961 and 1972 water in the small Molokai town was fluoridated.

Children on nearby Lanai may have the same bright smiles in their future with the state Department of Health and the private Lanai Water Co. wisely moving ahead to fluoridate water. If all of Hawaii's county water systems did the same, residents throughout the state would enjoy the benefits of improved dental health.

The Health Department for years has tried to get a bill through the state Legislature to require counties to fluoridate public water systems, but resistance from several residents and from a few state lawmakers citing possible adverse health effects have stymied the effort even though no such effects have ever been documented.

Fluoridation has been used safely in the United States for more than 55 years. A survey last year evaluated 50 years of research on fluoridation and found no evidence of harm from adding the substance to water, confirming numerous other studies that showed the same results.

About 65 percent of the total U.S. population drink fluoridated water, according to the U.S. Centers for Disease Control. Honolulu is the only one of the nation's 50 largest cities that does not fluoridate. As a result, Hawaii has more than twice the national average of tooth decay, with Lanai having the worst problems, said Dr. Mark Greer, chief of the state Dental Health Division.

Social and economic inequities may often leave those who most need it most without the benefits dental health care, Greer says. Fluoridation levels the field, giving access to even the poorest in the community. Further, fluoridation reduces health-care costs down the line. The CDC estimates that every dollar spent on fluoridation saves $80 in dental-care costs.

Fluoridating water is inexpensive. Investing in equipment and operating expenses for Lanai's water system will total about $100,000 for the first year. After that, annual costs will be about $2,000, a minimal amount weighed against the benefits.

Health officials have established baseline data and will study dental health improvements on Lanai over the years. The benefits and disadvantages, however, are readily evident from Maunaloa's experience. When the water was fluoridated, tooth decay among children decreased 62 percent, according to the Health Department. When Maunaloa discontinued fluoridation, tooth decay increased 95 percent.

Said Greer, "It really is that simple."

Published by Oahu Publications Inc., a subsidiary of Black Press.

Don Kendall, President

John Flanagan, publisher and editor in chief 529-4748;
Frank Bridgewater, managing editor 529-4791;
Michael Rovner,
assistant managing editor 529-4768;
Lucy Young-Oda, assistant managing editor 529-4762;

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