NEW YORK (Reuters Health) - Antismoking policies targeting youths won't significantly reduce the number of smokers in the US for decades, according to researchers at the Pacific Institute for Research and Evaluation. Campaign efforts should be directed to

Recent policies to reduce tobacco use have focused primarily on youths, justified by the high rate of smoking initiation before age 18. Laws have limited cigarette sales to minors while school-based education programs and antismoking advertising have targeted adolescents. But the new study findings, published in the August issue of the American Journal of Public Health, journal of the American Public Health Association, suggest that these antismoking campaigns may have a more limited effect on reducing the national smoking population than experts previously thought. The investigators, led by Dr. David T. Levy, developed a model to evaluate the overall effect youth-related polices might have on current and future smoking rates. Using birth, death, and smoking rates from 1993 as a baseline, the researchers used computer spreadsheets to predict the various outcomes of antismoking efforts through the year 2043. In the first scenario, the researchers assumed no change in the smoking rate over the 50-year period. The second scenario considered what might happen with a 50% reduction in smoking. Two more scenarios looked at a 100% reduction and a 100% reduction with the assumption that some (about 25%) would start smoking after age 18. Investigators found that even under optimal assumptions, the smoking rate took decades to fall. In the first scenario assuming status quo could be maintained, the model predicted smoking rates might be 15% of the total population or 41 million people by 2043, a decrease from the 19% (48 million people) in 1993. With a 50% reduction, the smoking rate would drop to 14% in 20 years and just under 11% (30 million) in 50 years. Even if a 100% reduction in smoking rates could be achieved, the model projected that the ``rate of smoking would not be halved until about 2028, 35 years into the future,'' Levy and colleagues note. After 50 years, the number of smokers would have fallen about 13%, still leaving over 15 million smokers. ``Efforts to reduce tobacco use among adults are likely to have a more immediate payoff...than a policy that is focused largely on youth prevention,'' Levy's team concludes. That does not necessarily mean giving up current policies, however, according to Rae Jean Proescholdbell, an antismoking policy researcher at Arizona State University. ``What (this study) is saying is that if we ignore adults, it will take a very long time to see results and in the meantime, we're spending lots of money on smoking-related health problems,'' she said. ``I see this as an argument or good reason to target both adolescent and adults. Smoking is so complicated and addictive that we really need to use all the methods we can to reduce or prevent smoking.''

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