Educators are targeting younger and younger children to teach them about the dangers of smoking.
The efforts now extend to kindergarten children - almost all of whom are not interested in smoking at all. But antismoking groups believe the only way to counter the effects of tobacco company marketing, peer pressure, and adult smoking is to start educating children well before they are interested in tobacco products.
Recently, Scholastic Magazine and the American Lung Association introduced a new book, "The Berenstain Bear Scouts and the Sinister Smoke Ring," which is aimed at second- to fifth-grade children. Last year, the American Medical Association (AMA) began a cartoon character, "The Extinguisher," a superhero who rescues kids who are going to vending machines for cigarettes or wearing clothing promoting tobacco products.
The cartoon character, supplemented by an actor who travels around the US, is aimed at children kindergarten through Grade 5. And Weekly Reader, which competes with Scholastic, is planning an April cover story for Grades 3 to 6 on the detrimental effects of smoking.
Antismoking advocates believe it's worth trying such approaches. "We don't know if it will be successful unless we try it," says Nancy Kaufman, a vice president at the Robert Wood Johnson Foundation in Princeton, N.J.
She says one reason past efforts have failed is because they have been one-shot programs in health classes. Instead, she says what may be successful is teaching kids about smoking in media literacy classes, social studies, or other areas that have a context kids can relate to.
Influence of peers, ads
Trying to reach younger children is a necessity, says John Pierce, a professor of cancer prevention at the University of California, San Diego. Mr. Pierce says research has shown that kids start the process of smoking prior to the age of experimentation, which is usually ages 12 to 15.
William Novelli, executive director of the Campaign for Tobacco-Free Kids, observes that most children start off with a dislike of tobacco. Most preteens consider smoking "yucky" or "dirty" and are repelled when they smell cigarettes.
But only a few years later, some of those same children are willing to try a cigarette with a friend. "Something happens," Mr. Novelli says. "Some of it is peer persuasion, some of it is advertising and marketing."
To measure susceptibility to smoking, researchers ask children if they would be willing to take a cigarette from a friend. If a child says he or she "probably" won't take the cigarette, Pierce has found the child is at risk to smoke.
Pierce's research has found that at age 10, 15 percent of the children said they "probably" wouldn't take the cigarette, while 85 percent said they "definitely" would not. By age 13, 50 percent indicated they "probably" would not. "The susceptibility is there at a younger age," Pierce says.
Initially, it seems as if it would be easy to reach young kids with an antismoking message. But according to Stan Berenstain, author of the Bear Scout book, it's not so simple.
Twelve years ago, then-Surgeon General C. Everett Koop suggested to Mr. Berenstain that he write an antismoking book using his bears. "He observed that kids found the characters persuasive," says Berenstain, who resisted because he found it too difficult to handle smoking issues, such as peer pressure and advertising, in the 32-page format he used at a previous publisher.
After he joined Scholastic in 1995, he started writing longer, more complex books, designed for a slightly older readers.
Scholastic agreed to publish a 116-page book, in which the Bear Scouts face the advertising prowess of the Moose Tobacco Company and its Moe Moose mascot. Interspersed are vignettes about peer pressure and the difficulty of convincing bear cubs that smoking is bad for them. "It's got a health message," Berenstain says.
David Biro, a Montclair, N.J.-based writer, says it's important to communicate with kids in their language. For example, Biro sometimes writes his anti-tobacco messages in rap, a form of musical poetry. He has produced radio spots aimed at preteens and teens for a local advocacy group. In one spot, a singer spits out, "Studios may think it's Down/Treating you like a Clown/Their breath smelling like a Hound/But we don't smoke."
"You have to try to make smoking unhip," says Mr. Biro, who is now trying to start an antismoking cartoon series called Sumo Baby and the Blade Brigade.
Getting the message across to children has generated some controversy in the past. In November 1995, the Institute for Health Policy Studies at the University of California in San Francisco released a study of how smoking is portrayed by Scholastic and it main competitor, Weekly Reader.
The study was prompted by a Weekly Reader cover story in October 1994 on Smokers' Rights. Weekly Reader is owned by K-III Communications, which in turn is owned by Kohlberg Kravis & Roberts (KKR). At the time KKR owned a portion of RJR Nabisco, the parent of RJ Reynolds Tobacco. "They tried to make the case we were promoting RJR," says David Adler, a spokesman for K-III.
Sandra Maccarone, editor-in-chief of Weekly Reader, says the publication had a long history of writing about smoking's dangers but decided to run a story that smokers were fighting back.
Today, she says, "We always do smoking with the slash through it and have had one cover story with someone stomping on a cigarette," she says.
To expand the antismoking message further, Scholastic, in conjunction with Novelli's group, has started a pilot project called the Educator's Alliance for Tobacco-Free Kids. According to a Scholastic spokeswoman, this is a group of teachers "leading the fight against tobacco." The teachers will get free teaching materials and support from local health organizations. However, the Alliance does not include Weekly Reader, which reaches 9 million children.
How Parents Can Help
What should you do if you find cigarettes in your child's possession?
Don't panic, says an expert on adolescents.
"The worst thing a parent can do is start forbidding and trying to dictate," says Loren Tarshis, who works closely with teens as the editor of Choices, a Scholastic health magazine. "Parents have to realize this is not an affront."
Instead, Ms. Tarshis recommends:
* Ban smoking at home or on the family property. "You can make it more difficult to smoke," she says.
* Try to make yourself an ally in healthy decisions by offering your child incentives to quit smoking. For example, "If you quit smoking, you'll get that new mountain bike you've wanted."
* Become an expert on what your child likes. Watch some MTV. Read their magazines and find out about their role models. This may become helpful. For example, some rock stars are now trying to quit smoking. Point this out.
* Tarshis says the best defense is to create an antismoking environment even before the child enters the age of experimentation.
"Cigarettes need to be stigmatized, made gross," she says. Point out to the child how the tobacco companies market their products. When you are on the road, have the kids count tobacco ads instead of license plates.
"Be alert for fodder for outrage," she says.