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REMARKS BY: DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES PLACE: International Policy Conference on Children & Tobacco ,Washington, D.C. DATE: March 18, 1999
Together with the American Cancer Society, the American Public Health Association, the Campaign for Tobacco Free Kids - and, of course, UNICEF, WHO and, our host, the OAS - they each deserve our gratitude.
And, in that regard, let me also extend the appreciation of President Clinton and Vice President Gore to all of them - and to each of you -- for your participation in this vitally important conference.
Together with the WHO Interregional Focal Point Meeting in Egypt last December and our more recent meetings in Geneva this past January, I think this conference will be remembered as another milestone in our worldwide campaign against tobacco use.
On a personal note, I also want to tell you how proud I am to share today's program with Dr. Gro Brundtland.
At the time she stepped forward to assume her post as WHO director-general, I think we all expected great things. She has not disappointed us.
And I am delighted that Dr. Brundtland has become the supreme commander of the world's fight against tobacco.
As I was preparing for this conference, I was reminded of an observation made by a friend of mine, the writer and commentator Ben Wattenberg. In a response to those who warned that the American electronics industry was becoming a thing of the past, Ben brought up an important point.
He said that while it's true, for example, that very few video cassette recorders are manufactured in the United States, when people buy those VCRs and take them home, most of the movies they're going to watch are American made. And it's not just movies. It's also music and it's television programs.
In fact, of everything the United States exports, probably the most significant in terms of its impact on the world in general - and its young people in particular -- is popular culture.
It's movies by Steven Speilberg. It's songs by Madonna. It's the excitement of watching Shaquille O'Neal on a basketball court. It's the reason why young people in Norway and the Philippines know all about Star Wars. And why you'll see young people from Zimbabwe to Turkey to Thailand wearing Chicago Bulls tee shirts.
What the U.S. exports is popular culture and some of our very best customers are also some of the world's youngest. That's why it's so appropriate that this conference is happening here. Because, one of the things we've exported to young people along with our movies, our music, our television programs and our sports are some dangerous and irresponsible messages about tobacco.
The message from the tobacco industry - mine in particular -- has been that smoking is mature. That smoking is sophisticated. That smoking is macho for guys - and sexy for girls. In essence, it's that smoking is fun. That it's beautiful. That it's cool.
And tobacco companies have constantly reinforced this message by presenting smoking as an essential element of American culture. I have one pack of cigarettes here with me that was marketed in Russia. The name of the brand? American Dream. It even has the Statue of Liberty on it. And that's only where it begins.
In Beijing, Philip Morris produces the "Marlboro American Music Hour" featuring songs by Michael Jackson and Elvis Presley.
In Japan, the company uses American actors like James Coburn and Robert Wagner in commercials pushing Lark cigarettes.
And, in Russia, the company even sent a traveling disco with a light show and professional dancers to Siberia. It was advertised for a month. The price of admission? Well, you couldn't get in with money. No, you had to show up with five empty Marlboro packs.
Now, I'm from Cleveland, Ohio, which, as some of you may know, is the home of the Rock and Roll Hall of Fame. And, I have to tell you, I can't think of anything more antithetic to what rock and roll music is supposed to be all about than young boys and girls becoming addicted to tobacco!
Yet, this is the message the tobacco industry is sending the world's young people 24 hours a day, seven days a week. As a citizen of this country, I'm offended to know that tobacco companies are using my country's music and films and sports to peddle their products to children overseas.
And, as Dr. Brundtland said this morning, this promotion seems to be working. In Latin America, three- fourths of smokers started lighting up between the ages of 14 and 17. The first smoking survey of primary school children in Hong Kong revealed that one in five girls had smoked by the age of 13.
Again, I am offended, but the Clinton administration has resolved not just to talk about the problem, but to do something about it.
Let me be clear: We understand what it means when WHO projects that, in 25 years, 10 million people will die annually from tobacco use. And that 7 million of those deaths will be in the developing world: in countries where young people's hunger for U.S. culture has too often led them to U.S. cigarettes.
Against that backdrop it's little wonder that Carol Bellamy of UNICEF has described tobacco as one of the main violators of children's rights around the world.
That's why our President and Vice President haven't only concerned themselves with battling tobacco use in the United States, but also supporting your efforts to challenge the industry's efforts worldwide.
In February of last year, our State Department issued a new directive on tobacco policy. This policy made it crystal clear that our diplomatic corps should work to support tobacco control efforts in their host countries.
We directed our posts not to challenge host country tobacco laws and regulations so long as they were based on sound public health principles -- and applied equally to both imported and domestic tobacco.
Even more, we instructed our posts not to promote the sale or export of tobacco - and not to help U.S. citizens or companies that do. For example, that means no more U.S. embassy participation in any events promoting tobacco.
And, just this January, we took our efforts a step further when our Agency for International Development approved its own policy on tobacco. As a result, USAID will not support the growth of tobacco as a cash crop, nor support any business activities that in any way contribute to the production, promotion or use of tobacco at all. But it doesn't end there.
In countries where tobacco is a major cash crop for low-income farmers, our new policy also commits USAID to work with growers to introduce alternative crops.
As each of you and your governments are committed to doing your part to fight the use of tobacco, we are absolutely committed to doing our part.
Let me discuss the other major components of our strategy with you.
First, as you know, one of the single most effective tactics to discourage young people from smoking is to raise prices. Here in the U.S., President Clinton has proposed a 55-cent a pack price increase. This increase -- when added to the price hikes to come as a result of the $206 billion settlement of state litigation against the tobacco industry -- will unquestionably cut consumption among American youth.
Of course, raising tobacco prices here won't impact worldwide use unless other nations follow suit. And, as WHO proceeds with the Framework Convention, we're confident that will be an important priority. But fighting tobacco use among the young doesn't end with raising prices.
As Dr. Brundtland and others have pointed out, that's only where it begins. That brings me to my second point.
Governments must use their regulatory authority to restrict access to tobacco and to curb the industry's advertising. I'm not suggesting draconian measures to criminalize smokers, but common sense regulations to make it tougher for young people to purchase tobacco.
What that's meant in the U.S. is a new Food and Drug Administration regulation that not only requires that tobacco products not be sold to minors, but demands sellers see the identification of any purchaser under the age of 27. It's a simple measure, but it works.
We're also working to implement tough, new regulations that crack down on tobacco advertising even harder than we already have. However, as some of you know, those regulations are being challenged by the industry in court.
But the cornerstone to any effective regulatory strategy is information. That leads me to my third point.
Our experience here has taught us that tobacco control requires a comprehensive surveillance system.
In essence, as the tactics of the industry and patterns of use begin to change we need to be able to change with them. For example, we're currently seeing alarming growth in the popularity of cigars among young people.
If we're going to effectively combat dangerous new trends, we first need to collect better data. In the U.S., we're beginning the process by collecting local and brand-specific data on cigarette use for the first time. This will allow us to identify companies whose products are being marketed to children and to hold them responsible.
Can this data collection process be expanded and coordinated with international efforts? I believe it can, and it should. But raising prices and better monitoring of the industry can only achieve so much.
Ultimately, winning the war against tobacco use by young people depends on our ability to beat the industry at its own game. And that leads me to my fourth point: communicating our message to youth in the language of youth.
If there's one lesson I think public health professionals could learn from our duel with the tobacco industry, it's that the soundness of any argument is of little consequence if only a handful are listening.
Does that mean our arguments against tobacco have fallen on deaf ears? Of course not. In fact, last year we found that cigarette use among American high school seniors actually dropped off after reaching an 18-year high in 1997.
But while our campaigns against tobacco have resonated with some, they haven't been nearly as effective with the young people we need to reach.
In a similar vein, we print millions of informative brochures and pamphlets - all targeted at young people - but forget that, when young people get together with their friends, they don't read brochures. No. They listen to music. Or they watch the television. Or they see a movie. They surf the Internet. Or they play sports.
The bottom line is that we can't expect young people to speak our language, it's up to us to listen and to learn to talk in theirs. Last year, for example, my department recruited the musical group Boyz II Men to help us get our anti-smoking message across to kids. Now, I'll admit, I didn't know much about Boyz II Men, but that didn't matter: young people in this country do. And, to their fans, a message against tobacco from Boyz II Men means more than the studies of a dozen Nobel laureates.
Again, we need to speak in the language of the young. That's the idea behind a series of television advertisements that have been broadcast in Florida and Massachusetts.
Instead of people like us sitting around a table deciding what arguments teenagers will respond to, the makers of these ads brought teenagers together. They found that what young people were most sensitive to wasn't necessarily the threat of dying from tobacco. What they responded strongly to were true stories about living with the suffering and disfigurement caused by tobacco.
Another argument that was particularly effective with teens had to do with tobacco companies themselves: the fact that these companies are deliberately trying to mislead them to get them hooked on smoking. One other point: teenagers also believe it's important to point out how, together, they could do something about it.
How effective have these ads been? Five months after the United for Truth campaign began in Florida, one survey of kids aged 12-to-17 found that 92 percent of teenagers were able to describe at least one of the campaign ads and its theme. The survey also showed an increase in negative attitudes about smoking and tobacco companies.
Now, would these ads work as well outside of the U.S.? My guess is they wouldn't. After all, these were crafted by - and for - U.S. teenagers. But while these specific ads may not work, I'm convinced asking young people themselves for their input will.
The truth is that, wherever they live on this earth, young people must be seen as part of the solution.
As I mentioned a moment ago, here in the U.S., 46 states, six territories, and the District of Columbia will be receiving some $206 billion dollars as a result of their settlement with the tobacco companies. By any measure, it's an enormous amount of money. The State of California alone is due to receive over $25 billion dollars.
It's our hope that as policymakers decide what to do with this money, they'll choose to use much of it to finance innovative, new programs that can produce this kind of advertising.
Unfortunately, many different groups are lobbying to have these funds earmarked for a variety of other uses - many having no connection with tobacco and public health at all. But given the scope of the problem we're faced with, I think it's only appropriate that the states invest these funds in reducing tobacco use among the young.
Because what we have to overcome in this country - and throughout the world -- is decades of one of the most effective misinformation campaigns ever executed. It's been a misinformation campaign that not only uses music and television and film, but also sports.
From auto racing to wrestling to cricket, the association of sports with cigarettes has become a sad fact of life. Well, I'd like to invite you to join me to help keep that from happening to one sport before the tobacco companies get their foot in the door. I'm talking about women's soccer - or, as everyone but Americans call it, football.
Today, women's football is the fastest growing sport in the world. It's a sport that my department has taken a special role in promoting among U.S. girls. We believe that women's football can play an important part in helping motivate young girls to get involved in sports - and, in the process, help reduce their risk of smoking.
But we also know that, if the tobacco industry has its way, women's football could become just one more vehicle to peddle tobacco to the next generation. To help guarantee that doesn't happen, we've launched an initiative to keep women's football smoke free. And with the Women's World Cup Soccer Tournament to begin in the U.S. starting June 19, we don't have a moment to waste.
If you haven't received it yet, you'll be getting copies of material our department is distributing among girls to promote smoke free women's football. But we can't do the job alone.
I know that there are delegates here from at least seven of the countries that will have teams competing in the women's world cup. I ask you to join with us, and work with us, over these coming months to help keep women's football smoke free.
At an early point in World War II, Winston Churchill once said that it was not yet the beginning of the end, but it was the end of the beginning. That's how I feel about our war against tobacco. While we know we cannot claim that victory is within sight, we also know what it will take to make it inevitable.
What it will take is:
None of these goals will be easy to meet, but I'm convinced that all of these goals can be achieved. That's President Clinton's and Vice President Gore's agenda. And I look forward to working with you to help make it happen.
We are in this together and, together, I know that we can cut through the tobacco companies' smoke screen and, in the process, save the lives of millions of young people.