WAKE UP, Maryland! A miracle remedy for our state's long-lamented cancer death rate - fourth highest in the nation - lies 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 premature death without new budget investments or bureaucracy. All the children need is the clear-headed support of voting citizens.
How? They have come maddeningly close already. Last summer, eight teen-agers fanned out across Maryland like Joshua's scouts into Canaan. Trained by state revenue officers, they busily offered to buy cigarettes at 881 Maryland retail stores over a two-week period. They met no resistance at 110 of 115 vending machine sites (96 percent), or at 371 of 766 clerk-tended counters (48.5 percent). Because Maryland, like every state, bans cigarette sales to buyers under 18, the monitoring revenue officers could have - should have - followed right behind with a citation for the vendor each time a teen-age spot checker obtained cigarettes. If they had done nothing more than this, the lethal commerce of child addiction would be flushed out toward extinction by now.
But timid state authorities stopped short. For fear of political controversy, they made the two-week effort a "study" instead of an enforcement drive, and even that was undertaken under mandate of federal law.
The survey merely confirmed what every teen-ager knows: Tobacco enforcement is a joke. Although Maryland statutes more than a century old (dating back to 1886) decree that those who sell tobacco to minors shall pay fines ranging from $300 up to $3,000 for repeat offenses, there were no such cases brought 1995 and none yet reported for 1996. Zero. It is small comfort that many states do no better. Virginia has not punished a single underage tobacco sale since 1990, and an embarrassed Gov. George E. Pataki is scrambling to find a solitary example in New York.
Our dizzy priorities come straight out of Alice in Wonderland. In one of 136 workplace inspections last year, MOSH officers fined President Carolyn Manuszak $1,312 for smoking alone in the bathroom of her private office at Villa Julie College, thereby protecting from secondary smoke anyone who might have breathed tobacco fumes that escaped her bathroom door or window. No such effort protects the 60 Maryland kids who become new smokers each day, supplied by illegal but more or less open transactions. A third of these new smokers eventually will die early of tobacco-related heart or lung diseases - roughly 6,000 per year by the mid-21st century. Their extra health care will cost Maryland roughly $170 million a year at today's prices.
Similarly, Maryland troopers who rightly scour every jurisdiction for highway speeders give no thought to state laws on underage tobacco sales. No one expects them to, even though:
* Smoking kills eight people for every traffic fatality.
* More than 80 percent of those who ever smoke begin illegally before 18.
* Youth smoking has risen 50 percent in the 1990s. About 20 percent of eighth graders now qualify as regular smokers. More than 30 years after the tobacco companies grandly pledged to end marketing to those under 21, the high school smoking rate of 35 percent now exceeds the legal, adult rate of 25 percent.
Today's teen-age smokers are tomorrow's terminal patients, just yesteryear's new smokers produced nine new lung cancer patients in Maryland every day. Their chances of surviving five years after detection are stuck at a chilling 13 percent, because lung cancer resists new treatments that have cured or retarded other cancers, such as those of the stomach, cervix and liver. Lung tumors now kill more Marylanders than breast and prostate cancers combined. A lag time of decades means that the death rate among women has grown fivefold since 1960, in the era of tobacco-marketed liberation.
Why do we put up with this? How can the epidemic of youth smoking continue when all parties, including the tobacco companies, proclaim their dedication to stop it?
A smokescreen of arm-waving gestures leaves us apathetic and blindly misguided. Suppose for a moment that we tried to enforce highway laws the way we control nicotine traffic. Troopers who chase down mad motorists would be authorized only to hand out "Speed kills" bumper stickers and recommend safe driving classes. Judges might allow lawyers to argue in the abstract how fast one might "intend" to go, but courts would never act upon or even consider any driver's actual speed.
The obvious vulnerable spot of youth smoking is the illegal flow of money at the point of sales. Tobacco smoke is nasty and unpleasant even for the "coolest" beginners, and experimental smokers require convenient nurturing to develop an addiction that demands constant supply. This "hooking" phase is not a pretty part of the business, which makes cigarette defenders extremely sensitive about point-of-sale enforcement. They stave off the whole idea with their favored alternatives:
* Sticker displays, warnings, "mandatory" ID checks, training programs for clerks, rules on the placement of vending machines. Such plans sound vigorous and promising, but they always skirt the central question of enforcement.
* Education . Cigarette promoters prefer education campaigns to enforcement, which they reject as "anti-business." In fact, spot-check fines are the most economical, least intrusive tool against underage smoking. They avoid cumbersome regulations and paperwork. The method does not interfere with adult smokers, and leaves proprietors free to decide for themselves how to make sure no underage smokers buy cigarettes on their premises. It pinpoints irresponsible vendors with fines heavy enough to make youth sales lose money. Honest, diligent vendors (roughly half the stores in last summer's study) not only escape fines but enjoy relief from unfair competition.
* Punishment for children instead of vendors. In 1994, lobbyist Bruce Bereano and tobacco forces deftly reshaped an enforcement bill to focus new penalties on the young buyers of cigarettes. Their maneuver subverts the entire rationale for underage tobacco law, of course, which holds adults accountable for fateful smoking decisions by minors.
* Blaming middle-schoolers and high-schoolers is ineffective, unprincipled, and downright ghoulish, because nicotine addiction fastens even harder upon children than adults. Half of Maryland's eighth-grade smokers say they have tried to quit already - and failed. Ninety-five percent of new teen-age smokers say they intend to quit within a year, but only 25 percent succeed within a decade.
In a pinch, tobacco interests will say that enforceable spot checks by a few deputized teen-agers would "corrupt" our youth in tattletale crime - never mind the comparable effect of routine sales welcoming thousands to the big illicit ashtray. Or they object that the economy cannot stand a serious drive against illegal smoking - as though Maryland's prosperity really depended on turning a fresh supply of pink lungs into soot-seared crusts.
These evasions should surprise no one. It is their practice to blow smoke rings and our choking task to see through them. What galls is that big tobacco regards states like Maryland so lightly.
Although the Clinton administration's pending regulations on youth marketing are limited, and subject to lengthy constitutional appeal, the Tobacco Institute is fighting them desperately because the stakes and the relative integrity of federal politics are so high. Tobacco also fears the myriad local governments as unpredictable, though puny, and has pushed through the legislatures of 27 states recent boilerplate laws that curtail or forbid local ordinances on cigarettes.
Ironically, tobacco works hard to stay in the hands of the very jurisdictions that have the acknowledged power to enforce laws against underage smoking - the states. Why? Maryland and sister states have proven to be docile pushovers for scofflaws in the cigarette business.
The General Assembly now meets in Annapolis. Rumors fly of bank-shot deals that might use profits of one crassly addictive new vice (slot machines) to shore up horse racing purses, cut pTC income taxes, and scuttle Gov. Parris N. Glendening's proposal to raise cigarette taxes. A jingle of hard cash echoes from the background.
This is our legislature. Plenty of good people serve in it, but voters are responsible for the outcome and the tone of debate. Whatever happens in the gambling-and-tax thicket, a strong resolution on youth smoking would shine with the courage of proper adults.
Instead of averting our eyes from garish sales to puffing kids, we could work a revolution of leadership against cancer and cynicism at once. We could restore faith with new generations that yearn - literally - to breathe free. The enforcement issue stands alone. It touches nothing but the self-respect of citizens and the health of our children.
Taylor Branch is the Pulitzer Prize-winning author of "Parting the Waters: America in the King Years, 1954-63."
Pub Date: 2/02/97