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Posted on 06/25/2002 1:16:19 PM PDT by Just another Joe

Health groups critical of new smoking age

By James P. Sweeney
COPLEY NEWS SERVICE

SACRAMENTO - When a West Hollywood legislator and a powerful doctor's lobby launched a drive earlier this month to raise the state's legal smoking age to 21, some prominent allies in the war on tobacco were conspicuously absent.

The proposal, which could make California the first state to outlaw cigarette sales to 18-, 19- and 20-year-olds, immediately drew national attention, including a poll that showed broad support for the idea.

Amid the applause, however, representatives of the state's heart, lung and cancer associations were sitting on their hands, or openly critical.

"It's silly," said Stan Glantz, a professor of medicine at the University of California, San Francisco and a leading anti-tobacco voice. "There is no good evidence that laws restricting sales of cigarettes to kids actually affect smoking by kids."

While it "sounds like a good idea," Glantz said, "it's just a waste of time."

Even worse, some public health advocates fear the measure may divert attention from a critical fight to preserve funding for a broad range of tobacco-control programs that have a proven track record in California.

With a state budget deficit approaching $24 billion, Gov. Gray Davis has asked for deep cuts in funding for the anti-tobacco campaign, a model that has pushed smoking rates to near national lows.

Long-term funding at issue

Long-term base funding for the tobacco-control program is at stake this year. One administration proposal would dedicate most of the state's $500 million a year from the national tobacco settlement to help balance the budget. That move alone could soak up some 80 percent of those funds for the next 22 years.

"In another year," said Lisa Rea of the American Heart Association, "maybe we would have gotten excited about" raising the legal smoking age to 21. "But it's not something that we can say is high on our priority list. It just isn't. The budget is everything this year."

Likewise, a spokeswoman said the American Cancer Society is taking no position on the legislation by Assemblyman Paul Koretz. The American Lung Association was initially ambivalent, but has since expressed support for the bill.

Only three other states have smoking ages higher than 18. In Alabama, Alaska and Utah the legal age is 19. Koretz's measure would be phased in so that it would not affect those 18 and older who now smoke.

The first-term Democrat is carrying the legislation for the California Medical Association, an organization of 35,000 physicians that has long been one of the state's most formidable political forces.

"Everybody accepts the idea that the drinking age should be 21 to reduce the number of traffic fatalities and other kinds of incidents," said Dr. Jack Lewin, the CMA's chief executive officer.

"The window of danger with alcohol is four to six hours after a teen-ager has been drinking. As physicians we know that the window of danger with tobacco is four to six decades."

Dr. Leonard Klay, a Santa Rosa obstetrician and gynecologist, persuaded the CMA's house of delegates to endorse the concept in February.

In the intervening months, the CMA and the public health groups discussed the timing of the legislation as the state's fiscal situation continued to deteriorate. The CMA declined to wait.

"It's very disheartening that we're not all together on this," said Ron Lopp, a CMA spokesman.

While many teen-agers are introduced to tobacco products long before they turn 18, Koretz and the CMA said most do not become addicted until they have easy access and can legally purchase cigarettes.

"It's easier to prevent smoking than it is to get people to quit," Dr. Klay said.

California's anti-tobacco campaign has pushed the adult smoking rate down to 17.4 percent, second only to Utah. But state data show that young adults have proven to be the toughest group to reach.

Smoking increases in group

Eighteen- to 24-year-olds are the only age group that has not shown a marked decline since 1989, when California initiated its aggressive anti-tobacco efforts. During that span, the number of 18- to 24-year-olds who smoke actually increased from 18.9 percent to 23.6 percent.

"By raising it to 21," Koretz said, "we dramatically reduce the number of people who are getting cigarettes at 16 and 17 by going into stores and looking close enough."

But Glantz, the UCSF professor, said age restrictions on tobacco sales are widely ignored and poorly enforced.

"We know that the way to reduce youth smoking is not by supply side controls, it's by demand reduction," Glantz said. "The state's anti-smoking program has achieved the lowest youth smoking rates in the country if not the world . . . and that's exactly what the governor is dismantling."

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