Shared Cause was instrumental in creating the National Center for Tobacco-Free Kids, the leading advocacy organization working to reduce tobacco use and its deadly consequences.

Tobacco Free Kids

The Challenge

In 1995, youth smoking was rampant.  Nearly 4.5 million American kids smoked more than 500 million cigarettes a year, and fully half of the 6 million users of smokeless tobacco products in this country were under 18.  Research tells us that addiction to nicotine takes place in the first few years of tobacco use, which means even children who experiment casually are at significant risk.  More than 50 percent of teenage smokers considered themselves addicted to cigarettes, and two-thirds of kids who smoked said that given the chance to do things differently, they would not have started a habit that could have such a profound effect on their lives.

At the time – 13 years after Surgeon General C. Everett Koop’s groundbreaking Report on Smoking and Health – Big Tobacco remained the least regulated industry in America.  Research funded by the Robert Wood Johnson Foundation (RWJ), though, yielded a critical insight:  While people tended to view smoking as a free choice among adults, they overwhelmingly opposed marketing to youth, recognizing that tobacco addiction typically begins in the teen years.

A 1994 national voter survey conducted by Mathematica Policy Research revealed that measures to restrict youths’ access to tobacco would receive broad support.  For example:

  • 94% of adults believed that vendors should be required to demand I.D. verification of any tobacco purchaser who appears underage.
  • 74% believed that all cigarette vending machines should be banned.
  • 78% would support laws requiring tobacco products to be kept behind counters to discourage kids from seeking to purchase or shoplift them.

Even among smokers, more than 90 percent felt more should be done to educate kids about the dangers of cigarettes.  Here was an unprecedented opportunity to establish policies in all states to restrict youth access to tobacco.  Doing so, however, would require translating passive support of a concept into real action.

As a committee of the Institute of Medicine stated, “A vigorous effort to prevent the initiation of tobacco use among children and youths must be the centerpiece of the nation’s tobacco control policy and should be among its highest public health priorities.”

Finding the Solution

RWJ took up the challenge.  Its response was to hire Shared Cause to help create a new entity solely dedicated to preventing youth smoking. 

We began by examining the current status of the tobacco control movement.  The effort to curb smoking involved a remarkable array of activity, ranging from community-based efforts led by schools and small groups of ordinary citizens to public education campaigns and health policy programs conducted by national health organizations.  Yet, this diversity was a weakness when confronting an industry whose communications and lobbying efforts were highly organized and heavily funded.  Through its Tobacco Institute and the National Smokers’ Alliance, the industry was able to present consistent messages to the public, keep legislators focused on their positions, respond swiftly to media inquiries or new findings on the health effects of tobacco, and pursue carefully-crafted, long-term strategies. 

An independent publication entitled, Covering Tobacco; A Handbook for Journalists, underscored the effectiveness of the industry’s communications apparatus:

“In most situations, the Tobacco Institute should be your first call to get the industry’s side.  The Tobacco Institute represents the six major cigarette manufacturers in the United States and is authorized to speak for them.  They can also put you in touch with industry scientists and scientists who have testified on the industry’s behalf, as well as industry-sponsored groups, such as restaurateurs opposing smoke free ordinances…”

We realized a movement to discourage children and teens from using tobacco would require a similar singular focus and authority on the issue of teen smoking.  We would need the capacity to ensure that messages were quickly and effectively communicated to the American public.  And we would need to craft and pursue comprehensive national strategies.

With the Robert Wood Johnson Foundation, we worked with leaders in public affairs, philanthropy and health to design what became The National Center for Tobacco-Free Kids. The core concept was the Center would take the lead in establishing an advocacy agenda, promoting related messaging, calling attention to industry practices and public officials’ support of Big Tobacco, and issuing calls to action.  Equally important, it would work with a wide range of partners, extending from the national to the community level, to make youth tobacco prevention a mainstream cause. The combined approach provided the tobacco control movement with unprecedented clout.

Shared Cause recruited a group of core partners – including the American Cancer Society, American Heart Association, American Lung Association and the American Medical Society – to join the Robert Wood Johnson Foundation in launching the Center for Tobacco-Free Kids with $31 million in funding.  The Center recruited an outstanding staff that translated its strategies into its public face, The Campaign for Tobacco-Free Kids.

The Result

Today the Campaign for Tobacco-Free Kids is the leading advocacy organization working to reduce tobacco use and its deadly consequences in the United States and around the world. 

Its core partners remain, and it works nationally with the CDC, the FDA and more than 100 state and community based organizations throughout the US and the world, with a budget of $25 million and a 49-member staff.

The Campaign’s leaders were deeply involved in the Master Settlement Agreement between the states and the companies that ended a series of lawsuits to recover the state-borne health costs of smoking.  

The Campaign’s efforts at increasing tobacco taxes, passing smoke-free workplace and restaurant laws and increasing funding for smoking prevention and cessation programs have resulted in real reductions in youth smoking.  Since the Campaign was created, youth smoking rates in the US have fallen from 36 percent to 11 percent – a 70 percent reduction.  Four states, including New York and Florida, have youth smoking rates under five percent.  Meanwhile, adult smoking rates have fallen from 42 percent to 15 percent.

Campaign President Mathew Myers reports, “The progress we are making is so swift that a 2016 New England School of Medicine study found if the US can maintain its recent rates of progress, we could reduce smoking to zero by 2035 and end the death and disease caused by tobacco.”

Of course, the struggle isn’t over, given the rise of e-cigarettes.  Fortunately, we now have a national organization and partnership that’s able to wage the fight effectively.