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February 2, 1997 Section F Suffer the children Maryland is doing little to stop youths from smoking Marlboro KOOL BYTAYLOR BRANCH Filter Kings AKE UP, Mary- W landi A miracle remedy for our state's long. lamented can- cer death rate fourth highest in the nation bes within reach. While complex plagues such as poor schools and job loss may require solutions not yet imagined, the scourge of cancer will yield to a small campaign led by children. A mere handful will do. They can arrest the long treadmill of costly suffering and prema- ture death without new Dud- get investments or bureauora- cy. All the children need is the clear-headed support of vot- ing citizens. How? They have come maddeningly close already. Last summer, eight teen- agera fanned out across Mary- land like Joshua's scouts into Cansan, Trained by state rev- enue officers, they busily of fered to buy cigarettes at 881 Maryland retail stores over a two-work period. They met no ASSOCIATED PERSO $ 1990 resistance at 110 or 110 vend- ing machine attes (95 per- cent), or at 371 of 766 clerk- Today's teen-age smokers are tended counters (48.8 per- cent). Because Maryland, like tomorrow's terminal patients, just as every state, bans cigarette sales to buyers under 18. the yesteryear's new smokers produced monitoring revenue officers could have - should have - nine new lung cancer patients in followed right behind with a citation for the vendor each Maryland every day. time . teen-age spot checker obtained cigarettes. If they had done nothing more than no such cases brought in 1996 transactions. A unind of these this the Mthal commerce of and none yet reported for new smokers eventually will child addiction would be 1996. Zero. # is small comfort die early of tobacco-related flushed out toward extinction that many states do no better. heart or lung diseases by now. Virginia has not punished a roughly 6,000 per year by the But timed state authorities single underage tobacco sale mid-21st century. Their extra stopped short. For fear of po- since 1990, and an embar- health care will cost Maryland litical controveray, they made rassed Gov. George K Pataki roughly $170 million a year at the two-week effort a "study" is scrambling to and a solitary today's prices. instead of an enforcement dri- example in New York Similarly, Maryland troop- ve, and even that was under- Our dizzy priorities come ers who rightly socur every Ju- taken under mandate of fed- straight out of Alloe in Won- risdiction for highway speed- eral law. derland. In one of 186 work- ers give no thought to state The survey merely con- place inspections last year, laws on underage tobacco firmed what every teen-ager MOSH officers fined Presi- sales. No one expects them to, knows: Tobacco enforcement dent Carolyn Manussak even though: is a joke. Although Maryland $1,312 for smoking alone in the 9 Smoking kitls eight peo- statutes more than a century bathroom of her private office ple for every traffle fatality. old (dating back to 1886) de- at Villa Julie College, thereby . More than ao percent of aree that those who sell tobac- protecting from secondary those who over smoke begin D. co to minors shall pay fines smoke anyone who might legally before 18. renging from $300 up to $3,000 have breathed tobacco furnes . Youth smoking has risen for repeat offenses, there were that escaped her bathroom 60 percent in the 1990s, About door or window. No such ef- 20 percent of eighth graders Taylor Branch 14 the fort protects the 60 Marytand now qualify as regular amok. Pulitser Prire-winning author kids who become new smok- ers. More than 30 yours after or Farting the Waters: Ameri- ers each day. supplied by the- the tobacco companies ca in the Xing Years, 1954-63." gal but more or less open grandly (Bee Tobacco, Brg Saving Md. youth the stakes the relative of federal polities are so high To bacco also fears the myriad local governments as unpredictable, though puny, and has pushed from big tobacco through the legislatures of 27 states recent bollerplate laws that curtan or forbid local ordinances on ciga- rettes. Ironically, tobacco works hard to stay in the hands of the very juris. [Tobacco, from Page IF) ers prefer education campaigns to dictions that have the acknowl- enforcement. which they reject as edged power to enforce laws pledged to end marketing to those "anti-business." In fact, spot-check against underage smoking - the under 21, the high school smoking fines are the most economical, least states. Why? Maryland and sister rate of 35 percent now exceeds the intrusive tool against underage states have proven to be docile legal, adult rate of 25 percent. smoking. They avoid cumbersome pushovers for scofflaws in the ciga- Today's teen-age. smokers are regulations and paperwork. The rette business. tomorrow's terminal patients, just method does not interfere with The General Assembly now as yesteryear's new smokers pro- adult smokers, and leaves propri- meets in Annapolis. Rumors try of duced nine new lung cancer pa- etors free to decide for themselves bank-shot deals that might use tients in Maryland every day. Their how to make sure no underage profits of one crassly addictive new chances of surviving five years after smokers buy cigarettes on their vice (slot machines) to shore up detection are stuck at a chilling 13 premises. It pinpoints irresponsible percent, because lung cancer re- vendors with fines heavy enough to sists new treatments that have make youth sales lose money. Hon- horse racing purses, cut income cured or retarded other cancers, est, diligent vendors (roughly half taxes, and scuttle Gov. Parris N. such as those of the stomach, cervix the stores in last summer's study) Glendening's proposal to raise ciga- and liver. Lung tumors now kill not only escape fines but enjoy relief rette taxes. A jingle of hard cash more Marylanders than breast and echoes from the background. from urifair competition. prostate cancers combined. A lag Punishment for children in- This is our legislature. Plenty of time of decades means that the stead of vendors. In 1994, lobbyist good people serve in it, but voters death rate among women has Bruce Bereano and tobacco forces are responsible for the outcome and the tone of debate. Whatever hap- grown fivefold since 1960, in the era deftly reshaped an enforcement bill of tobacco-marketed liberation. to focus new penalties on the young pens in the gambling-and-tax think- et, a strong resolution on youth Why do we put up with this? buyers of cigarettes. Their maneu- How can the epidemic of youth ver subverts the entire rationale for smoking would shine with the smoking continue when all parties, courage of proper adults. underage tobacco law, of course, Instead of averting our eyes from including the tobacco companies, which holds adults accountable for proclaim their dedication to stop it? fateful smoking decisions by mi- garish sales to puffing kids, we could work a revolution of leader- A smokescreen of arm-waving nors. ship against cancer and cynicism at gestures leaves us apathetic and Blaming middle-schoolers and once. We could restore faith with blindly misguided. Suppose for a high-schoolers is ineffective, un- moment that we tried to enforce new geserations that yearn liter- principled, and downright ghouldsh, because nicotine addiction fastens ally breathe free. The enforce- highway laws the way we control ment issue stands alone. It touches nicotine traffic. Troopers who chase even harder upon children than down mad motorists would be au- adults. Half of Maryland's eighth- nothing but the self-respect of citi- and the health of our children. thorized only to hand out "Speed grade smokers say they have tried kills" bumper stickers and recom- to quit already and failed. Ninety- mend safe driving classes. Judges five percent of new teen-age smok- might allow lawyers to argue in the ers say they intend to quit within a abstract how fast one might "in- year, but only 25 percent succeed tend" to go, but courts would never within a decade. act upon or even consider any dri- In a pinch, tobacco interests win Personname ver's actual speed. say that enforceable spot checks by The obvious vulnerable spot of a few deputized teen-agers would youth smoking is the illegal flow of "corrupt" our youth in tattletale conous money at the point of sales. Tobac- crime - never mind the compara- co smoke is nasty and unpleasant ble effect of routine sales welcoming 25 even for the "coolest" beginners, thousands to the big Dlicit ashtray. and experimental smokers require Or they object that the economy Fe cines convenient nurturing to develop an cannot stand a serious drive against addiction that demands constant illegal smoking - as though Mary- inwon supply. This "hooking" phase is not land's prosperity really depended a pretty part of the business, which on turning a fresh supply of pink makes cigarette defenders ex- lungs into soot-seared crusts. tremely sensitive about point-of- These evasions should surprise sale enforcement. They stave the no one. It is their practice to blow whole idea with their favored alter- smoke rings and our choking task natives: to see through them. What galls in Sticker displays, warnings, that big tobacco regards states like "mandatory" ID checks, training Maryland so lightly. programs for clerks, rules on the Although the Clinton adminis- placement of vending machines. tration's pending regulations on Such plans sound vigorous and youth marketing are limited, and push EO' forward wasses promising, but they always skirt the subject to lengthy constitutional central question of enforcement. appeal, the Tobacco Institute is push Education. Cigarette promot- fighting them desperately because California, ESQ. American Heart Association. They accuse state offi- Seque cials of trying to usurp the power of the voters and, in the process, do the bidding of the tobacco indus- try. "At stake is the people's constitutional right to adopt laws through initiatives and whether those laws Want a Bonus, Too? Don't Make Me Laugh will be fully implemented by the Legislature and the courts," says George Waters, of Sacramento's Olson, Hagel, Fong, Leidigh, Waters & Fishburn, the lead At the Los Angeles district attorney's office, where pros- attorney challenging the diversions. In suits filed in 1994 and again last year, Sacramento judges declared ecutors are still livid over the $43,000 in bonuses given last the diversions illegal. But the Wilson administration fall to Marcia Clark, Christopher Darden, and Bill Hodgman has appealed; with the 1996-1997 budget again call- for their work on the O. J. Simpson ing for tobacco-control funds to be shifted to indi- trial, wags have posted this "Application gent care, yet another legislative and court battle for 11% Bonus" on bulletin boards seems likely. Meanwhile, $160 million in disputed throughout the building. funds are frozen in the State Treasury. Like most ballot measures, Prop. 99 contains provi- 1. Case title for which the bonus is sions allowing for amendment-but only if the amend- requested: (Note: If the case does not ment is "consistent with the initiative's purposes." The have the potential for political impact, you main legal issue in the appeal is whether the diversions do not qualify.) meet that test. Last December, in Amwest Surety Insur- 2. How was the case assigned to you? ance Co. v Wilson (1995) 11 C4th 1243, the state (Note: Unless you actively pursued it Supreme Court handed nonsmoking groups some from the inception, you do not qualify.) ammunition, setting forth some standards of review for Jarden's bonus: $10,747 3. Will handling the case cause you to be more concerned about your appear- Prop. 99 is the only time ance and public speaking than your courtroom presentation? [Yes] [No] [Not Sure] Californians have voted to 4. Does your involvement in the case cause you to believe tax themselves. you are in need of a public relations manager? [Yes] [No] [Not Sure] [Hopefully] answering whether an amendment furthers an initia- 5. Will the case cause the office to provide a support staff and tive's purpose and ruling that the Legislature's amend- trial lawyers to handle any of the following types of witnesses: Evi- ment of Prop. 103, the insurance reform initiative, did dence collection; coroner; domestic violence; DNA; glove not. But Prop. 103 did not try to tell lawmakers how to experts (for cases where sizing deci- spend money. The Prop. 99 case sets the stage for the sions exist)? first appellate ruling on the Legislature's right to divert 6. Will the case require a case funds after special restrictions have been imposed on manager to assist in the day-to- their use by voters. "The essential issue is to what day trial decisions most deputy extent the Legislature is to be acceded a certain defer- district attorneys handle them- ence by the courts in its ability to enact laws and make selves on a daily basis? [Yes] [No] changes in initiatives passed by the people," says [Can't Decide] Christopher Waddell, the state Department of Finance's 7. In handling the case, will you be chief counsel. A hearing before the Third District able to confidently and consistently Court of Appeal is expected to be set for this summer. write unjustified accrued over- Anti-smoking groups warn that if the state pre- time without shame? [Yes] [No] vails, future drafters may write ballot initiatives bar- [Define "Shame"] 8. What was the result of the Clark's reward: $14,330 ring the possibility of any legislative amendment-a potential disaster, since amendments act as safety trial? (Note: Unless you lost the valves to correct mistakes and ensure future flexibility. trial, held a press conference claiming you performed admirably, Fed-up voters could take matters even further, warns lauded the performance of your "staff," and put your public image Fredric Woocher, of Strumwasser & Woocher in Los above all else, you do not qualify.) [Guilty] [Not Guilty] [Jury Angeles, who represents Americans for Nonsmokers' Deadlocked] [Don't Care] Rights in the suits. "If the people can't trust the 9. Are you willing to take an eight-month paid vacation at courts to enforce [their mandate] and the Legislature county expense while enduring the rigors and anxiety of book and proceeds to gut new measures the people not only movie negotiations? [Yes] [No] won't allow amendments, they won't approve bond DARDEN: AP PHOTO/ELISE AMENDOLA; CLARK: AP PHOTO/NICK UT (Final note: "No" responses to queries 6, 7, or 9 are cause for measures, initiatives, or taxes, and Sacramento won't automatic disqualification.) have the money to provide government services." -LOREN STEIN MAY 1996 22 CALIFORNIA LAWYER UT fornia, ESQ. STATE Smoke and Mirrors California's groundbreaking anti-tobacco program is caught in a constitutional battle over budgetary rights n other states, 1996 is turning out to be a terrible year for research and education to indigent medical care. Lawmakers tobacco companies, with at least six governors suing the argue, essentially, that the anti-tobacco program has been too industry to recover medical costs for smokers and the Liggett effective for its own good. As cigarette sales have dropped, so Group becoming the first cigarette maker ever to settle a smoking- has revenue from the surcharge, from $573 million in 1988- related lawsuit. But in California, lawmakers-with the blessing 1989 to an estimated $444 million for 1995-1996. According of the tobacco lobby and a powerful doctors group-are to pro-diversion forces, this shows that the anti-tobacco pro- expected to try for the third time to divert money from the gram is no longer as critical as it used to be; meanwhile, indi- state's anti-tobacco program, widely considered to be the most gent health care programs funded by Prop. 99 are in jeopardy. effective in the U.S. The battle has far-reaching implications for The amendments would cut education funds in half and vir- public health-and for the integrity of the state initiative process. tually eliminate research-total program funds would be Proposition 99, aka the Tobacco Tax Initiative, established a slashed to $50 million for the current fiscal year. The diversion 25-cent-per-pack surcharge on cigarettes and set aside 25 per- has overwhelming backing in the Legislature (a four-fifths cent of that revenue for anti-smoking media, research, and edu- majority is required to amend the initiative). It also has the cation (another 70 percent went toward health care, mostly for support of some strange political bedfellows: the California the poor). The measure, passed in 1988, is the only time Medical Association, which says health care for the poor is Californians have ever agreed to tax themselves, motivated more important than anti-tobacco programs, and the tobacco by the goal of reducing addiction and the long-term costs asso- industry, which spent $22 million trying to defeat Prop. 99 ciated with tobacco-related disease. In that regard, the initiative and is one of the biggest financial contributors in Sacramento. has been a resounding success, according to state and federal The funding shift is vehemently opposed by Prop. 99's studies. Adult per capita smoking has fallen more than three sponsors, including the American Lung Association and the times faster in Cali- fornia than in the rest of the country, ciga- rette sales have plum- Recession Alert: Bankruptcies Are Booming Again meted 41 percent, and 300 communities have adopted no- M ore proof that the economy is less rosy than some would have us believe: After a two-year decline, bankruptcies jumped 11.3 percent last year nationwide. More smoking ordinances. proof that the pain is not being felt equally: While personal bankruptcies (Chapter 7 But over the same and Chapter 13) rose 11.7 percent, business bankruptcies (Chapter 11) fell 12.7 percent. In period, the state has California, bankruptcies edged up 2.8 percent, with filings almost unchanged in the Central become increasingly District (although in absolute terms, the Los Angeles area remains the bankruptcy capital of desperate for money. the universe). But filings were up 11.2 percent in the Eastern District (based in Sacramento), Thus, twice in the 6.1 percent in the Southern District (San Diego area), and 4.2 percent in the Northern Dis- past two years, Gov- trict (based in San Francisco). While Wall Street romps and executives' salaries soar, "[most] ernor Pete Wilson people's take-home pay is declining," explains Daniel G. Bath, a bankruptcy attorney and com- has requested-and mercial litigator at Cummins & White in Los Angeles. "There's not a lot of cash out there, but the Legislature has consumer credit is very easy to obtain, and people have taken advantage of that." The Ameri- ED RACHLES passed-bills amend- can Bankruptcy Institute echoes this view: It says credit card delinquency rates are at their ing Prop. 99 to shift highest level since the 1991 recession. -KELLY FLAHERTY money from tobacco CALIFORNIA LAWYER 21 MAY 1996 Clinton Presidential Records Digital Records Marker This is not a presidential record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. This marker identifies the place of a publication. Publications have not been scanned in their entirety for the purpose of digitization. To see the full publication please search online or visit the Clinton Presidential Library's Research Room. HEALTH POLICY Child Health PROMOTING AWARENESS OF MOTHERS AND CHILDREN IN STATE AND NATIONAL HEALTH POLICIES AND PROGRAMS Lawmakers Debate Strategies to Reduce Tobacco Use Among Youth Every day, 3,000 Americans under 516 million packs of cigarettes and 26 The the age of 18 become regular smok- million containers of chewing tobacco a George ers-a statistic with enormous implica- year, according to a 1994 report from the Vashington tions for the nation's health. The leading Surgeon General. More than three mil- University WASHINGTON DC cause of premature death, tobacco use is lion of those teens smoke cigarettes, MEDICAL CENTER responsible for more than 400,000 deaths while one million use smokeless tobacco CENTER FOR each year. And as experts in the field products. The mean ages for trying a first HEALTH POLICY RESEARCH point out, adolescence is the key period cigarette and for initiating smoking on a in the decision to start smoking: the vast daily basis are 14.5 years and 17.7 years, Center for the Future of Children majority of adult smokers had started by respectively. By age 18, about two-thirds The David and Lucile Packard their 18th birthday and more than half of adolescents in the U.S. have experi- Foundation smoked regularlyby that age. On the other mented with tobacco. hand, people who do not begin to smoke Teen smokers are fairly evenly divided Spring 1996 as minors are unlikely to ever do SO. between males and females, while smoke- Volume 3 Number 2 In view of those facts, state and federal less tobacco users are almost exclusively policymakers continue to explore a range male. Smoking is much more common YOUTH AND TOBACCO 1 of strategies designed to reduce tobacco among white youth than black youth States apply a variety of use among youth. Some of the initiatives (22.9 percent vs. 4.4 percent). According approaches to reverse trends in target easy access to tobacco products by to a report released in February by the tobacco use among adolescents teenagers and even younger children, Centers for Disease Control and Preven- and even younger children. while others aim to limit the appeal of tion (CDC), the percentage of youth who SPOTLIGHT ON 6 tobacco to young people. But while ap- reported smoking in the last 30 days var- HIV testing of newborns Immuni- proaches such as health education enjoy ies from 16.7 percent in Washington, DC zations in Missouri Arkansas widespread support, others, including re- to 38.9 percent in West Virginia. and managed mental health care strictions on advertising and sanctions for Most alarming to the health com- New rule on lead poisoning young users, are being sharply debated. munity is that after a sharp decline in RESOURCES 7 Disagreements among lawmakers on the smoking in the 1970s and a continued Publications, reports, etc. best approach in part reflect different be- slow-down in the 1980s, smoking is FOR THE RECORD 8 liefs about who bears the major respon- again increasing among American youth. Some of the striking statistics from sibility for youth smoking: tobacco Among both eighth- and tenth-graders, CDC's report on tobacco and teens companies, retailers or young people the proportion who report smoking in the in the 1990s. themselves. past 30 days has risen by a third since SPECIAL REPORT Pullout 1991, according to a December 1995 re- A special commentary looks at the Young Smokers: A Profile port from the University of Michigan, links between children's health, Almost 1 in 3 young people under age while the proportion of high school se- poverty, and welfare reform 18 uses tobacco, consuming a cumulative niors who smoke has increased by >