Ideas for antismoking messages

Canadian Medical Association Journal 1996; 154: 1318

[Letters]

Iam responding to the articles in the Jan. 15 issue of CMAJ on smoking. Teenagers start smoking because of peer pressure. Few adults start smoking, and most wish they could stop.

Consequences and fear have failed as deterrents. Could a cartoon with the theme "Are you still doing that kid stuff?" tarnish the glamour of smoking as a rite of passage?

An effective cartoon could also be the subject of a postage stamp. Other countries have found stamps to be a money-making way of getting an antismoking message to a wide audience and to be preferable to an expensive advertising campaign. The tobacco lobby may object, of course.

Gordon J. Mack, MD
Vernon, BC

[Dr. Frederic Bass responds:]

Children do not start to smoke as much as they slide into it: one seminauseating dose of nicotine at age nine, then one or a few cigarettes per week for several months or years, then cigarettes every day. During this period of experimentation physicians may have considerable influence. Unfortunately, there has never been a randomized controlled trial of physician-based prevention of smoking to prove the point. Once young people start smoking daily, the reinforcing effects of nicotine and social pressure drive home the addiction.

Concerning consequences and fear not serving as deterrents, we must be careful to recognize which consequences are relevant to preteens and teens. Proving that you are no longer a small child and being independent, tough, cool, thin and glamorous -- these are what count! So let's be relevant. Teens could be asked: "How do you feel about giving up your money for cigarettes? About having bad breath? About becoming addicted to cigarettes? About losing a summer job that a nonsmoker gets? About being less attractive to someone of the opposite sex because you smoke?"

Concerning the tobacco epidemic and postage stamps, it is sometimes easier to take action than to prompt bureaucracy to do so. Therefore, the Tobacco and Illness Committee of the British Columbia Medical Association is planning to produce and make available at cost a rubber stamp with a strategic message about tobacco. Interested physicians can use the stamp on their envelopes. We invite readers to submit suggested messages for the stamp through CMAJ's letters to the editor. Let's make Dr. Mack's suggestion -- "Smokers, are you still doing that kid stuff?" -- the first one.

Frederic Bass, MD, DSc
Chair
Tobacco and Illness Committee
Council on Health Promotion
British Columbia Medical Association
Vancouver, BC

| CMAJ May 1, 1996 (vol 154, no 9) |