• 10/11/2004
  • Dallas-Fort Worth
  • By Lisa P. White
  • Star-Telegram.com

The mood is tense in the conference room where a dozen teen-agers have gathered. Their body language — eyes downcast, arms crossed, slumped in their seats — says they don’t want to be there. They have no choice. They’ve been caught.

They are among nearly 4,000 Tarrant County teens sent to anti-smoking school in the seven years since the Legislature enacted a tough law that penalizes minors who use tobacco and the retailers who sell it to them. Some of the dozen teens were caught smoking or using smokeless tobacco behind a school. Others did it in a parked car. One even did it in the back of a police cruiser, lighting up after he was caught smoking marijuana.

Now, for eight hours over four evenings, they must attend awareness classes at Tarrant County Public Health. The state program is designed to help minors break their tobacco habit before it’s too late. Police in Texas can issue citations to people younger than 18 who are caught using, buying or possessing tobacco products. Those who fail to attend the classes and pay a fine of up to $250 can lose their driver’s license for six months. Texas is one of 32 states that ban tobacco possession by minors, the American Lung Association says. But there is no consensus in the public health community about whether such laws are a deterrent.

A state Health Department study of Texas secondary-school students published in August found that for teen smokers, the threat of losing their driver’s licenses affected their decision to quit. The citation and the fine, however, had little effect, according to the 2003 Texas Youth Tobacco Survey.

“I think that these laws have been very differentially enforced, and we don’t have a lot of evidence that punishment for minors has an impact on youth smoking,” said Danny McGoldrick, director of research for the Campaign for Tobacco-Free Kids in Washington, D.C.

Scott Roesch, 17, a senior at Brewer High School in White Settlement, was among those in the recent class. He was caught smoking at a party, and his driver’s license was suspended when he failed to take the awareness course within the required 90 days. He also had to pay a $175 fine.

“I think a lot of people under 18 are doing it just because of the law … it makes smoking seem rebellious,” he said.

Tarrant County is second only to Dallas County in the number of citations issued since the law took effect. Police in Dallas County cities had issued 11,591 tickets through July; in Tarrant, the number was 10,192. Police in Fort Worth and Arlington each issued more than 3,000 citations. But court data suggests that enforcement varies in smaller cities. In tiny Dalworthington Gardens, for example, officers wrote 163 tickets. In Colleyville, which has almost 10 times as many people, police issued 92.

Fort Worth police, who recently received an $18,000 state grant, say they will continue to aggressively enforce the law. Officers wrote 728 citations from September 2003 through July, according to state data. Police in Dallas issued about half as many.

“Just like [with] alcohol, if they look like they are under 25 years of age, we have the reasonable suspicion to ask for ID,” Fort Worth vice officer Ed Adcock said.

For Roesch, who started smoking in middle school, getting cigarettes was never a problem. A fake ID, less-than-vigilant store clerks, older friends and willing adults all helped, he said. On Day Two of class, he tells the group that he hasn’t had a cigarette in days. But the weekend — with its temptations — looms.

Early intervention

Public health advocates say it’s important to stop smokers early. Most adult smokers picked up the habit while they were young, and health problems related to smoking cost the nation billions of dollars each year. In 1998, Texas spent $231 per person on medical expenses directly attributed to smoking, according to the latest figures available from the national Centers for Disease Control and Prevention.

The anti-smoking program is intended to be educational rather than punitive. Developed at Texas A&M and the University of Houston, it tries to help teens understand why they use tobacco and give them the skills to quit.

Keisha Leatherman, 29, a former health teacher, is in her second year of leading the Tarrant County course. She says she smoked once, in the fifth grade. She tries to correct students’ misconceptions about tobacco and to penetrate their adolescent bravado.

First, she uses the health argument. Graphic photos of a blackened, cancerous lung and oral cancer sores jolt the students out of their complacency. But after a lengthy discussion of cancer, heart disease, emphysema and reduced life expectancy, one boy says, “I heard somebody lived to 100 years old and still smoked.” Tobacco affects people differently, Leatherman responds, and the students shouldn’t take one experience as the norm.

Next, she tries the economic argument. The only smokeless-tobacco user in the group, a 17-year-old, is unmoved by the cost of his can-a-day habit.

“Two bucks is pocket change,” he says dismissively.

“It is pocket change that day, but over the course of your life it’s a lot of money,” Leatherman replies.

Even though more than half the teens said they need to start each day with a smoke, most said they can quit when they want to. They’ll stop in their early 20s, they said. By then, Leatherman tells them, “You’ll be five years more addicted.”

Insufficient funds

Fewer teens are lighting up in Texas and nationwide, but health officials and tobacco-control advocates worry that decreased funding for awareness programs could reverse the trend.

A $6.6 million cut has halved the number of people reached by a pilot program in Houston, Belmont and Port Arthur. Tobacco use among secondary students in the program had declined 36 percent since 1999.

“Tobacco is the No. 1 preventable cause of death, and we don’t have enough resources to implement the things we know will work,” said Phil Huang of the state’s Bureau of Chronic Disease and Tobacco Prevention, which runs the program. Texas is spending $7.4 million on prevention this fiscal year. That’s about 7 percent of the amount the CDC suggests should be spent.

Texans Investing in Healthy Families, a coalition of tobacco-control advocates, is lobbying for a dollar increase in the 41-cents-per-pack cigarette tax. They want 5 cents of every dollar earmarked for educating people about the dangers of tobacco use. Although the tax failed in the Senate during the last legislative session, it is being considered again, but mostly as a way to fund education.

Some success

On the final day of class, Leatherman sports a T-shirt that reads, “If you’re smoking around me, you better be on fire.”

The rapport she has built with the teens is evident. They have learned why they use tobacco — typically for pleasure and relaxation or to reduce stress, just like adults — and what triggers a nicotine craving. Of the 10 who made it to the end, eight say they want to quit or cut down. But a couple have already relapsed. The lone girl in class hadn’t smoked in nearly a month because she is pregnant. But, at her 15th birthday party, “everyone was doing it.” She did, too.

Roesch couldn’t get through a weekend party without a cigarette. Now he’s smoking about four per day.

“I want to quit, but then I don’t,” he said. “I just can’t make up my mind.”

The backsliding, Leatherman later said, is disappointing. But the class also yielded some surprises, like the 16-year-old cigar aficionado who came in with an attitude and, at the end, thanked her for helping him quit.

“For a kid to make the effort to thank me means a lot,” she said.

Teen smoking, in brief

9,000 — About how many Texas teens have lost their driver’s license for six months after violating the anti-tobacco law.

80% — Approximate percentage of adult smokers in the United States who started before age 18.

28.5% — Percentage of high school students surveyed nationwide in 2001 who reported that they had smoked at least one cigarette in the past 30 days. That’s down from a high of 36.4 percent in 1997.

69.3 — Packs of cigarettes per person sold by Texas retailers in 2001.

SOURCES: Texas Department of Public Safety, National Youth Tobacco Survey 2002, Centers for Disease Control and Prevention