Why Is Tobacco Still The Leading Preventable Cause Of Death?

STEVE INSKEEP, HOST:
It's MORNING EDITION, from NPR News. I'm Steve Inskeep.
RENEE MONTAGNE, HOST:
And I'm Renee Montagne.
Fifty years after the landmark surgeon general's report that smoking causes cancer, former U.S. surgeons general are emphasizing that the key in the fight against tobacco is kids. They gathered for a youth tobacco summit in New Orleans yesterday.
NPR's Debbie Elliott reports.
DEBBIE ELLIOTT, BYLINE: Former Surgeon General Regina Benjamin says no one wanted to believe Dr. Luther Terry back in 1964 when he said smoking led to disease and premature death.
REGINA BENJAMIN: Just like today, it was a lot of controversy. They released it on a Saturday, because they didn't want it to affect the stock market.
ELLIOTT: Still, it was big news.
(SOUNDBITE OF NBC NEWS BROADCAST)
UNIDENTIFIED MAN: Here is NBC News correspondent Frank McGee.
FRANK MCGEE: This book containing 387 carefully worded pages is a federal government report. It's title: "Smoking and Health."
ELLIOTT: Every surgeon general since has issued a report detailing tobacco's toll on society, and much has changed. Cigarette packs have warnings. You can't smoke in most public spaces, and there are restrictions on the way tobacco products are made and sold. Smoking rates have dropped from nearly half the American public to just about 18 percent of adults. There's no dispute that nicotine is addictive and tobacco is deadly.
So why is tobacco still the leading preventable cause of death, killing 1,200 people a day? Benjamin says it's because for every smoker who dies, there are two so-called replacement smokers trying a cigarette for the first time and getting hooked.
BENJAMIN: Ninety percent of all smokers start before age of 18, 99 percent before the age of 26. So if can just get our next generation to not take that first cigarette before the age of 26, they have less than 1 percent chance of every starting. And we can make that generation tobacco-free.
ELLIOTT: So, the key, she says, is stopping the next generation from ever taking that first puff. Dr. Benjamin is now an endowed chair of public health sciences at Xavier University in New Orleans. She invited all the living surgeons general to join her on campus to focus on youth smoking.
Dr. Anonia Novello was surgeon general in the early '90s.
ANONIA NOVELLO: It's the only legal product that utilized, as it says, it will cause you death. So we have to get that message into their heads.
ELLIOTT: Experts say the best messenger is their peers.
(SOUNDBITE OF MUSIC)
UNIDENTIFIED CHILD: (Rapping) Too many youth and young adults be dying. I don't mess with that tobacco. Oh, no. It ain't cool. Did you know three million students smoke in high school?
ELLIOTT: This anti-tobacco video by Florida middle-schools is the winner of a contest sponsored by Benjamin, when she was surgeon general. For the Xavier summit, she recruited teen advocates to sign what she calls TobaccNO pledge, inspired the video.
DESHANDA SMARR: I pledge to be tobacco-free for those who passed away, because they wasn't strong enough to fight against tobacco.
ELLIOTT: Deshanda Smarr is a 16-year old high school student from Atlanta. She says smoking is a problem for kids her age.
SMARR: A lot of youth say it's because of stress, but they're too young to stress. I don't think that's the reason. I actually believe it's because they see other people do it, especially adults.
ELLIOTT: College freshman Darrien Skinner of San Marcos, Texas thinks the nation's policy needs to change.
DARRIEN SKINNER: We all know that tobacco is bad. So why does it still exist in society? Why is it still here today? Why isn't the government stepping in and changing it?
DAVID SATCHER: Well, ultimately, I think that's the direction we're moving in.
ELLIOTT: Dr. David Satcher was the 16th U.S. surgeon general.
SATCHER: You could argue that we shouldn't have to do that, that if we do our jobs in public health, that people will just stop smoking.
ELLIOTT: The former surgeons general have mixed opinions on whether tobacco should ever be outlawed, a controversial topic in a society that values personal choice.
Debbie Elliott, NPR News, New Orleans. Transcript provided by NPR, Copyright NPR.