Last week, California announced that smoking rates here have dropped to historical lows. Only 15.4 percent of adults in the state smoke. This represents a 32.5 percent drop in the number of smokers here since 1988 (ABCnews). In fact, the state has been so successful they have set the bar for other states. How has California done it? And why have we made so much progress while other states struggle to reduce their number of smokers?
If you watch any amount of television, chances are you’ve seen some of the new generation anti-smoking ads. In 1997, the state began using tax dollars to fund a bold advertising campaign. The goal? To show the ugly realities of smoking in ways that actually make an impact. The spots are often gruesome, sometimes clever, and always hard-hitting.
One ad flashes back and forth between scenes like sides of a coin. A hip young man with a slightly arrogant air about him walks by, flippantly saying he can’t even get out of bed without having a cigarette. The scene flashes to another room where an obviously ill man lies in bed struggling to draw in rattling breaths. In a scratchy voice he says he can hardly get out of bed at all; he’s too tired just from trying to breathe. Another frame captures an attractive young woman responding to someone off camera. She dismisses the idea of even trying to quit smoking; she doesn’t want to gain any weight. The next scene is of another woman, bald head covered with a scarf. She can’t seem to gain any weight. The chemotherapy makes her too sick to eat at all. The ad closes with a final juxtaposition. A young man says he can’t quit while a doctor, MRI films in the background, says he can’t operate.
As young adults, we find ourselves in the difficult position of still believing in our own immortality. Today is so bright and vibrant, it’s practically impossible to make decisions based on the possibility of distant consequences. I believe that is why it’s so hard for young people to quit smoking. If the consequences were immediate, then our ability to mitigate our actions would improve dramatically. Instead, we are asked to struggle through discomfort and withdrawal in the name of longevity. It’s difficult to work hard in the present in order to avoid consequences that often don’t feel real.
The new ads have been so effective because they bring us face to face with the real dangers associated with smoking. But these ads alone cannot explain why California has made so much progress, especially when compared with other states.
Local efforts and state-wide legislation have contributed as well; organizations like the American Lung Association and the American Heart Association have been especially active in our schools and communities while legislation has banned smoking in most public places. In 1995, regulations were enacted to prohibit smoking in the workplace. And, in 1998, bars and restaurants went smoke-free (Center for Disease Control and Prevention).
All of these efforts together have made a significant difference. For perspective, consider Nevada. According to the CDC, Nevada has more deaths attributable to smoking then any other state. They do not have a smoke-free workplace policy, and because of the casino industry, it’s unlikely that will change. They are also one of many non-preemptive states where cities and counties are prevented from enacting any legislation tougher than what is in place at the state level.
When you consider that over half of the states have non-preemptive clauses written into their smoking programs, it’s no wonder they are having a hard time matching California’s success.
Despite the advances we have been making here in California, cigarette smoking is still the most important source of preventable and premature death worldwide. In the United States smoking is linked to approximately one in every five deaths, and has killed over 440,000 people a year from 1995 to 1999. Most of these deaths are the result of lung cancer, coronary heart disease, and chronic airway obstruction. Smoking also remains most common in people 18-24 years old (American Lung Association).