Health news Health & Medical News Philly is No. 1 in youth smoking

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Philly is No. 1 in youth smoking

Some facts about tobacco, teenagers, and Philadelphia:

Eighty percent of stores that sell cigarettes are located within 1,000 feet of a school. Kids who try to buy tobacco succeed 20 percent of the time. Merchants who sell illegally to people under 18 are mailed a $100 ticket for the first, second, or even seventh violation.

The result, officials say, is the highest youth-smoking rate among comparable big cities - a statistic that City Council is expected to attack Thursday by raising the fine for underage sales to $250 and streamlining the process to temporarily shutter businesses after three violations.

"They stare at me for, like, seven seconds, and then they just go reach for the cigarettes and hand them to me," said RaeNa Johnson, 16, who has bought tobacco from city retailers thousands of times during the last two years in undercover compliance checks that are run by most counties. "They obviously didn't care about health or that we could get addicted to nicotine at a young age. . . . They were getting $7 per pack."

Researchers say teen smoking is closely tied to money. Greater disposable incomes largely explain why white youths smoke at much higher rates than black and Hispanic youths - and also why average national rates and Pennsylvania and New Jersey rates are actually far higher than in Philadelphia.

And the relatively low prices that children pay for cigarettes and that merchants pay for illegally selling them to children help explain much of why more teens smoke in Philadelphia than in other cities.

The current fine is "a joke" and the increase only slightly better, said Nicholas Maiale, who opened Big Nick's Cold Cuts in South Philadelphia 36 years ago. With a mother-in-law who died of lung cancer and a sister who lost a lung, Maiale - himself a two-pack-a-day smoker who has repeatedly tried to quit - said he cards every teen and has lost not just tobacco sales but also candy, soda, and Tastykakes sales to competitors who don't.
"Kids know where to go," he said. "They are going to do it again and again and again."

Statistics compiled by the city show that Philadelphia has 4,398 tobacco retailers, or 27 for every 1,000 children ages 10 to 17 - double the ratio in Chicago, San Diego, and New York. Forty percent are within one block of a school, 80 percent within two blocks.

"As kids are walking to and from school, they are exposed to a lot of tobacco advertising," said Giridhar Mallya, director of policy and planning for the Philadelphia Department of Public Health, adding that manufacturers responded to increased ad restrictions by relying more on retailers to get out their message.

Tobacco excise taxes, which are controlled by the state, mean that cigarettes in Philadelphia cost $6 to $7 a pack, compared with $8 to $9 in Boston and, with a recently approved increase, nearly $11 in New York City, he said. And if a pack is too expensive, retailers here, many of them small operations, also seem more willing than merchants elsewhere to sell "loosies," he said - two cigarettes for $1.

More than a third of teens in the city buy tobacco directly from a shop, officials said, another No. 1 for Philadelphia.

"They can bum and borrow, but when they actually can buy their own cigarettes, [smoking becomes] much harder to control," said pediatrician Sara B. Kinsman, who works with adolescents at Children's Hospital of Philadelphia.

Smoking causes youth health problems, worsening asthma for example. .But the biggest concern about youth smoking, Kinsman said, is that 80 percent of adult smokers started in their teens.

It is a circular problem in Philadelphia, which has some of the highest adult smoking rates among big cities. Youths here "grow up in environments where they see adults smoking," Mallya said.

Among children, the rate is almost entirely a white phenomenon: More than 15 percent of white students in ninth through 12th grade said in last year's national Youth Risk Behavior Survey that they had smoked on at least 20 of the last 30 days. That's five times the Hispanic rate and 14 times the black rate.

Public-health workers say white teens have more money than minority youths to spend on cigarettes.

That situation changes when they reach adulthood. Philadelphia's adult smoking rate - 27 percent in 2008, according to the regional Household Health Survey - is almost identical among the three groups.

The city has no authority over tobacco taxes and limited control over the number of retailers, who can get a state tobacco license for $25. So officials have focused on illegal sales to teens.

For years, a retailer who sold tobacco to an undercover "youth surveyor," observed by an adult, would receive, several weeks later by mail, a $100 summons, similar to a parking ticket. Even when the Department of Licenses and Inspections shut down a repeat violator, Mallya said, the shop owner could pay a fine and reopen the same day.

The ordinance scheduled for a final Council vote Thursday would enable city workers to deliver, within two days, the summonses that currently go by mail and would use the opportunity to educate shop owners.

Other jurisdictions do far more.

New Jersey law, which defines underage as younger than 19, fines the clerk who makes the sale, rather than the owner, at a rate of $250 for the first violation up to $1,000 for the third. A judge signs off on all cases and adds $158 in various fees.

Pennsylvania law, which is far newer than Philadelphia's, applies to the rest of the state. Both owners and sellers are held responsible, with graduated fines of up to $5,000 for a retailer's fourth offense and $100 to $1,000 for the clerk. A district justice must sign off on all cases.

Philadelphia Health Commissioner Donald Schwarz told Council that he would love to treat underage sales as a criminal offense but that Municipal Court simply could not deal with 1,000 more cases a year.

Philadelphia is increasing its compliance checks to more than 8,000 this year using federal stimulus dollars.

The news is grimmer elsewhere.

Faced with budget cuts, Pennsylvania and New Jersey have sharply reduced money for prevention, including compliance checks - a big worry for suburban health officials, who have seen their rates of illegal sales plummet from 50 percent to under 10 percent over the several years that the programs had been in full swing.

Retailers respond to the checks, said Melissa Rankin, who oversees tobacco control for Chester County. "And they do talk," she said. "When he is in Coatesville, the 7-Eleven will call the WaWa and say, 'Hey, they're out.' "

Source: Health News , By Don Sapatkin "Inquirer Staff Writer"

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