Oklahoma Rising?: Part two, Teen smoking 

State pride swelled and the nation took notice as Oklahoma celebrated its first 100 years in 2007. After sweeping up the confetti, our state embarks on a new century invigorated with promise and hope.

While the state leads the nation in many respects, Oklahomans face significant hurdles that continue to challenge our spirit and resolve. Believe it or not, our fair city and state still dwell in the basement in several categories nationwide.

A cornerstone of Oklahoma Gazette's mission is to improve the quality of life in Central Oklahoma. Our six-part "Oklahoma Rising?" series examines several categories where our city or state ranks last. We'll examine why we're there, explain some of the root causes and look forward to alternatives for a better tomorrow.


Two weeks ago, when a state board in charge of managing funds to combat tobacco use announced this year's fight would be backed by $15 million, it seemed like a shoe snuffing out a cigarette butt. However, it might take a size 20-wide foot to stamp out the state's tobacco addiction, with the hardest fight taking place in the halls of Oklahoma's high schools.

Oklahoma has been near the top of the tobacco use list for several years. Whether categorized by age, tribe or gender, the state's ranking on tobacco consumption usually starts in the single digits. But three years ago, one number stuck out.

The Centers for Disease Control and Prevention's biannual report on smoking and tobacco use placed the Sooner state at the top among youth cigarette usage for 2005. The report showed 28.6 percent of high school students in grades nine through 12 engaged in cigarette smoking. It was a dramatic jump from 2003 " the first year the state participated in the survey " when Oklahoma ranked sixth at 26.5 percent.

One question: Why?

"It's a complex issue," said Dr. Laura Beebe, director of the new Oklahoma Tobacco Research Center at the OU Cancer Institute. "A lot of the factors that relate to teen smoking relate to adults as well. Eighty percent of adult smokers started when they were teens. We used to think the number was 90 percent."

Beebe also pointed to the state's profile.

"Oklahoma's demographics are such that the tobacco industry would find the markets in Oklahoma as ideal to test new products because we have a significant portion of our population that is low socioeconomic status," she said. "These are the targets for the tobacco industry and Oklahoma has pretty good representation in that area."

Ten years ago, 46 states negotiated a deal with the four largest tobacco companies to settle a landmark class-action lawsuit over the states' loss of billions of dollars to smoking-related diseases. 

The Tobacco Master Settlement Agreement arranged for the companies to pay states a total of $206 billion. Oklahoma's share was estimated to be $2 billion over 25 years.

With this influx of anti-tobacco cash, it was expected Oklahoma would start to reduce its smoking rates.

The latest report from the CDC has the state's lungs a little clearer. Oklahoma dropped 5 percentage points among rates of teen smoking to 23.2 percent, moving the state back down to the No. 7 spot.

Same question: Why?

"The first year we had any money to spend was 2003, and we had about $500,000," said Tracey Strader, executive director of the Oklahoma Tobacco Settlement Endowment Trust. "When you see the (state) treasurer's (press) release of $15 million, it's not like we've had $15 million to be spending all these years. It has been a gradual movement."

Unlike other states, Oklahoma established the trust fund, which holds 75 percent of the tobacco settlement money. The state can only use the earnings from the trust fund to spend on anti-tobacco programs.

Trust fund officials say this has given Oklahoma a slower start than other states on reversing the state's youth prevalence of smoking.

If Oklahoma's soldiers enlisted to fight the tobacco battle are going to win, they will need to strike at teenagers like Desireé King before the tobacco companies do. A senior at Northwest Classen High School, King picked up the habit at age 13.

"The first time I did it, I didn't do it right," she said, standing outside her English class. "I choked on it. I couldn't breathe. I could not stop choking."

Experts say what caused the girl to even pick up the cigarette in the first place is one of the leading causes of youth smoking.

"I guess because my mom and dad do it," King said. "I was like, 'Hey, what does it feel like?'"

The fact that King picked up smoking from her parents should not surprise anyone, especially in Oklahoma where one out of every four adults smokes. The CDC's 2007 survey found Oklahoma comes in third place for adult cigarette use with 25.8 percent " up two spots from 2005, which placed the state at the 25.1 percent mark.

"Since we have higher smoking prevalence rates among adults in this state, we can expect the perceived social norms around smoking to be a little bit incorrect," Beebe said. "If teens think more people smoke, they are more likely to accept smoking as a social norm and more likely to experiment and initiate smoking as well."

Experts claim enticing teens to smoke comes from a three-pronged approach: marketing, peer pressure and role models such as parents or other siblings. Peer pressure and role models, while powerful in their own way, take a back seat to what anti-tobacco advocates say is the king of enticement: marketing.

"I think there are larger tobacco companies out there that are not targeting, but are less sensitive, so their marketing materials tend to catch the eye of youth," said Bobby Stem, a lobbyist who represents tobacco companies like Oklahoma-based Xcaliber and the tobacco interests of the Choctaw Nation.

Stem said neither Xcaliber nor the Choctaw Nation targets youths in any of its products or marketing.

"Their demographic is late-30 males," he said. "Their studies have shown their main customers are males going through a divorce who need to downgrade their tobacco costs."

While new laws and the settlement agreement between states and tobacco companies have severely restricted the means by which cigarettes may be advertised, tobacco companies have not sat around waiting for smoking traditions to be passed down to generations. Through the Internet, direct mail and social networking, cigarettes continue to infiltrate mass markets and teenagers.

"We've got significant industry practices and, in fact, studies have shown that the role of tobacco marketing actually does account for more of the experimentation that does occur, as compared to peer pressure," Beebe said. "I think as professionals and educators and parents, we often think that it's purely a peer-pressure issue."

Internal tobacco company documents obtained by the states through the lawsuit show the industry's obsession with getting teenagers hooked on tobacco. A document from 1978 discusses one company's strategy to sponsor youth sport teams, providing scholarships for underprivileged youth and sponsoring Miss Black Teenager contests, according to published findings from the case. The strategy was to help promote a new brand of cigarette, Newport.

"I smoked Newport more than any of them," King said, who is now 17.

A 1983 document from R.J. Reynolds Tobacco Company talks about connecting to youth through the then-new arcade craze by giving away video game tokens with cigarette purchases.

But the settlement agreement put an end to blatant youth marketing. Bans were placed on using cartoon characters like the Camel brand's popular Joe Camel. Outdoor advertising on billboards and public transportation facilities were also nixed.

The restrictions may have rid the public of overt marketing to teens, but experts say that hasn't stopped tobacco companies from targeting youths. They point to elaborate Internet sites and free cigarette giveaways at local bars and clubs as ways big tobacco has adjusted to the advertising constraints. The promotion at bars and clubs involves the electronic scanning of driver's licenses.

There is one other form of product that marketing experts say is solely targeted at youth.

"I don't think anyone can argue that flavored cigarettes are not targeting teens," Beebe said. "When we've got cherry vanilla Marlboros or Virginia Slims that are in beautiful packaging and have these kind of candy or sweet flavors, it's obvious that marketing is targeting certainly young adults, and I would even go lower and attribute that kind of marketing to teens as well."

When asked about flavored cigarettes, King didn't hesitate.

"You mean Prime Time," she said.

That relatively new brand of smoking tobacco is actually miniature cigars packaged as cigarettes. They come in a variety of flavors like cinnamon, chocolate mint, peach and grape.

"They have a little taste to them," King said. "The cherry kind doesn't really taste like cherry. I tried that one once."

Just as the experts regard the tobacco war as a three-pronged attack, their solution is also based on the power of three: better public policy combined with community programs and backed by a strong media campaign.

"What the research tells us is it's the comprehensive approach that will yield the biggest impact in terms of preventing smoking initiation and encouraging smokers to quit," Beebe said. "By themselves, the impact is a little questionable. But as part of a comprehensive program, they are important to preventing teens from smoking."

On the public policy front, the goal is simple: Make Oklahoma a tobacco-free state. Advocates want nothing less than a total ban on indoor smoking at public places.

But the No. 1 target concerning public policy is to get rid of the pre-emption clause, which prohibits cities from enacting stronger legislation than what the state has passed.

"The way smoke-free laws have happened in other states is the communities went smoke-free until you had a critical mass and the legislature couldn't say, 'This isn't what everybody wants,'" said Sjonna Paulson, director of communications for OTSET. "In Oklahoma, we can't do that."

OTSET and the Oklahoma State Department of Health would also like to see a bigger increase in the tobacco tax. There is evidence a high price tag on the cost of cigarettes works. In June, the state of New York increased the tax on a pack of cigarettes, giving the state the highest tobacco tax rate in the country, with a pack costing nearly $7.

New York health officials said the state's smoking rates for youth have dropped to its lowest levels in 20 years.

Besides taxing, other ideas exist to lower youth smoking rates. Stem said his clients would even support raising the minimum smoking age to 21.

Attempts at curbing marketing ploys were addressed during the past legislative session. Sen. Randy Bass, D-Lawton, introduced a bill prohibiting the scanning of driver's licenses for marketing purposes " a tactic used in clubs and bars by tobacco companies. The bill passed unanimously in the Senate, but died in the House.

The second approach deals with funding community programs. This is one of the main functions of OTSET. But because of the state's constitutionally mandated formula for trust funds, by a vote of the people in 2000, the dollars have only trickled in.

"The one downside to these press releases is the public thinks we've been spending that amount, and we simply haven't," Strader said. "As a result, instead of starting with a comprehensive approach with all the pieces that needed to be done at once, we've had to layer them in as the money becomes available and expand from there."

One of the first programs put in place was the toll-free Oklahoma Tobacco Helpline. The service is set up to help those who want to quit smoking. During the 2007 fiscal year, more than 18,000 people in Oklahoma registered for Helpline services.

The third prong is a massive media campaign, which OTSET has embarked on for the first time this year. The "Tobacco Stops with Me" campaign was launched in January to emphasize how tobacco plays a part in the everyday life of Oklahomans, and what can be done to reduce tobacco use. The campaign involves television, radio and billboard advertising, along with an interactive Web site.

All of the approaches are aimed at preventing youth like King from picking up a cigarette. It is something her English teacher, Becky Feldman, has been working on for eight years with her creation of SWAT: Students Working Against Tobacco.

"I really started the club because the kids wanted it," Feldman said. "What we're really fighting against in SWAT is to stop kids from starting to smoke. A lot of them start when they are sixth, seventh and eighth grade."

King said she knew about the health risks when she started smoking. But Beebe said such risks don't resonate with teenagers.

"Teens are here and now," Beebe said. "They're living in a world of immediate reaction, satisfaction. Let's face it: Most of the health effects occur five, 10, 20 years after someone becomes a regular smoker. It's a developmental issue. Those kinds of messages hold very little meaning to a teenager. 'Don't talk to me about lung cancer in 20 years because I'm not thinking that far.'"

But King said she has thought enough about it.

"I'm getting out of the habit of doing it. I don't want to wake up one day and my teeth are yellow, my breath smells bad," she said. "I really shouldn't continue on, because there are moments when I can't breathe."  

Don't tell Doug Matheny that Oklahoma has toughened up on tobacco. The service chief of the state health department's Tobacco Use Prevention Service can point out every flaw with each attempt the state has made at curbing tobacco use.

He labeled the Smoking in Public Places Act of 1987 " the state's first attempt at restricting tobacco use " as the "guaranteed smoking in places act."

"It was a tobacco industry Trojan horse stuffed with a pre-emption clause in it," Matheny said. The pre-emption clause prohibited cities from passing tougher tobacco laws than the state.

How about the ban on smoking indoors at public places passed a couple of years ago?

"The act exempts a lot of working places, like restaurants," Matheny said, referring to the clause that allows restaurants to have a special ventilated room for smoking. "There is still a smoking room at the state Capitol."

And the compromise between the state and American Indian tribes on an increase in the tobacco tax in 2003?

Matheny said the tax rate wasn't strong enough to make a significant difference.

As one of Oklahoma's generals in the tobacco fight, Matheny has seen plenty of battles in the retail stores and the legislative offices. While pointing out some of the progress the state has made, he said he believes current law is a major obstacle to greatly improving the state's tobacco statistics.

"The tobacco industry was successful in Oklahoma in taking away the rights of cities and towns to do anything beyond state law," he said. "We are among the two worst states, among the few that have pre-emption at all. Only Oklahoma and Tennessee have this super pre-emption. It is so strong, it doesn't allow anything stronger than state law on tobacco, period."

The tobacco industry has heavily invested in the Oklahoma Legislature to keep smoking laws at bay. Since 2002, tobacco companies and interests have donated more than $1.6 million in campaign contributions. Much of that comes from tobacco giant Philip Morris, which has donated more than $1 million alone. "Scott Cooper

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