Transcript: Assistant Sec. Howard Koh warns growing underage tobacco use imposes heavy burden on U.S. health system
Transcript of remarks by Dr. Howard Koh, Assistant Secretary of Health, on the Surgeon General’s report on underage tobacco use (March 8, 2012):
“We’re here today to bring new heightened urgency to the tremendous public health burden that tobacco continues to impose on our youth – a burden that’s completely avoidable and completely preventable.
“Too many of our children are addicted. Too many cannot quit. And too many go on to die far too young.
“In fact, as you heard from our Secretary [Kathleen Sebelius], each day more than 12,000 people die due to smoking and each death is replaced by at least 2 new smokers under the age of 26.
“I have personally witnessed the cycle of dependence and despair as a physician who has cared for patients for over 30 years. And I can tell you it is heartbreaking when our patients tell us that they want to stop smoking but they haven’t yet been able to do so. And it is tragic when our lung cancer patients tell us that they started smoking as kids years ago to be cool and to impress the other kids next door.
“Today we understand even more clearly that youth smoking is not an accident. It doesn’t just happen.
“Each year, the tobacco industry spends $10 billion on marketing and promotion of tobacco products. This exceeds $1 million an hour, over $27 million a day, in the U.S. alone.
“The tobacco industry says that their intent is only to promote brand choices among adult smokers. But there is a difference between stated intent and documented impact. Because regardless of intent, the impact of tobacco marketing is to encourage underage use. And in fact, nearly 90% of smokers start by age 18 and more than 80% of underage smokers choose brands from among the top 3 most heavily advertised.
“You will hear in this report a major conclusion that advertising and promotional activities by tobacco companies cause – cause – the onset and continuation of smoking among adolescents and young adults.
“Research documents a dose response relationship. The more young people are exposed to marketing and promotional activities, the more likely they are to smoke.
“Far too many kids still see smoking images and messages everyday that normalize this dependence.
“For example, in 2010 nearly a third of the top grossing movies produced for children contain images of smoking. Just about half of our states continue to allow smoking in public places. Images and messages normalize tobacco dependence in magazines, on the Internet, and at retail stores. In short, kids see smoking in the movies they watch, the video games they play, the websites they visit, and in the communities where they live.
“From 1997 to 2003, youth smoking fell rapidly. But since that time, the rate of decline has slowed. In fact, there would be 3 million fewer smokers today if we as a society has sustained success in declines seen between 1997 and 2003.
“And of great concern, we are also seeing youth consume other tobacco products, including smokeless tobacco, hookah, and small cigars. So in total, we can now document at least 3.6 million youth cigarette smokers as well as 1.7 million adolescents using non-cigarette products such as smokeless tobacco products and little cigars.
“Moreover, many young people are concurrently using multiple types of tobacco. In fact, among those who use tobacco, more than half of high school males and nearly a third of high school females use more than one type of tobacco product whether it be cigarettes, cigars, smokeless tobacco, or some other form.
“This Surgeon General’s report not only provides powerful details about the factors that lead to youth use but also identifies proven, effective strategies that can advance prevention.
“We at the Department of Health and Human Services have committed to strengthening and fully implementing these proven, effective strategies as part of our comprehensive, coordinated national approach.
“In November 2010, we were proud to release ‘Ending the Tobacco Epidemic’ – a tobacco control strategic action plan for the United States from the Department of Health and Human Services. The plan sets forth specific actions where the department can implement progress, build on recent legislative milestones, respond to the changing market for tobacco products, and support robust tobacco control programs throughout the country.
“We have ample evidence that these comprehensive, multi-component interventions work. Such programs more than pay for themselves in terms of lives saved and dollars saved.
“The current problem is that we have not yet fully applied the evidence-based tools to end this epidemic. Between 2005 and 2010, 20 states had declines in smoking problems of 20% or more and that’s encouraging. But we to accelerate these declines in each and every state and sustain them to benefit all of our kids for the future.
“Until we end the tobacco epidemic, even more young people will become addicted, even more will die, and even more families will be left behind devastated by the loss of loved ones.
“So thank you so much for being here today. We must redouble our collective commitment to accelerating comprehensive programs, making cessation services accessible and affordable, creating an environment that de-normalizes this dependence and, most of all, give our young people a fighting chance to be healthy and tobacco free.”
- WhatTheFolly.com: Transcript: HHS Sec. Kathleen Sebelius says every tobacco death is replaced by 2 new smokers under age 25
- WhatTheFolly.com: Transcript: Surgeon General Regina Benjamin says U.S. can end youth smoking epidemic
- Department of Health and Human Services: Surgeon General’s report on “Preventing Tobacco Use Among Youth and Young Adults” (PDF)
- Department of Health and Human Services: Surgeon General’s 2012 report on “Preventing Tobacco Use Among Youth and Young Adults” – executive summary (PDF)