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Smoking, Sex, and Health Care, Part 1

Using the media to project healthy messages to kids, for a change

Though my past columns have focused on the potential ill effects associated with youthful over-immersion in the media, in three recent news articles we find a storyline emerging with an opposing thrust. In pondering certain problems that affect American youth, the government has decided to counter these by using the media itself to project healthy messages to kids. Also, certain market-driven media products have inadvertently created certain positive effects on certain seemingly intractable problems. All three are worth exploring.

In two instances cited in recent news articles, the government calculated certain public dangers afoot and decided to weigh in via the expenditure of tax dollars and government expertise to offer remedies. The two problems: teen smoking and the lack of access to health care for many youth. In a third area of concern the makers of reality TV are impacting in a serious way on the problem of teen pregnancy.

First to the matter of smoking. In a recent interview with Mitch Zeller, the director of the FDA’s center for Tobacco Products, we learn of a government-generated media push called the Real Cost Campaign. First, Mr. Zeller lays out the problem: 90% of adult smokers initiated smoking before age 18, and second, cigarette smoking remains the leading cause of preventable deaths and disease in the US, despite its relative decline over the last few decades. The death toll remains over 480,000 per annum.

Very concerned abut these preventable deaths, which has at its core the harsh fact that many Americans grow addicted to nicotine at a very early age, the FDA began doing research on how to deliver messages to youths in order to prevents their ever becoming addicted to nicotine in the first place. FDA experts concluded that many youth might intellectually comprehend that they are elevating the risk of developing cancer and other severe disease through chronic smoking. But, on an emotional level, since these problems seem far in the future, youths are not impacted by the fear of cancer in the here and now. Rather, kids are more concerned by health risks related to physical appearance. Further, a youthful audience may yawn if delivered a lecture but instead respond to eye-catching presentations if one hopes to impact them enough to change their behavior.

Consequently the FDA decided to focus its anti-smoking message on certain cosmetic health care concerns of young people delivered in an ironic or humorous tone. The health concerns that impact on kids include skin wrinkling, gum disease and tooth loss.

In certain eye-catching commercial-length adverts placed in certain youth-popular sites, the FDA sets out to fight fire with fire, so to speak, catchy message about the dangers of smoking going toe to toe with catchy message created by the tobacco industry about how cool a smoke can be. In one such commercial, a youth enters a store and plunks down money for cigs. After the man behind the counter counts the cash laid out for the pack, he says it’s not enough. Casually the boy reaches into his pocket, grabs a pair of pliers, nonchalantly rips out two of his teeth and lays them on the counter. Nodding, the store employee now hands over the pack of cancer sticks.

In yet another commercial the cigarette is personified as a smoke-sized smack-talking guy who lassoes a few young smokers and drags them through their homes and school corridors outside where they light up. The idea here is that a cigarette equals addiction and one loses control of one’s own behaviors once one becomes addicted.

These memorable commercials are imbedded in websites and media places that youth frequent, so as to catch youth where they live. In an ongoing research format, the FDA is following 8000 youth for two years to gauge the impact of these ads on the youth’s behaviors. A pilot project to be sure, as the numbers are small, and the FDA is going up against both the media and the tobacco industries, which can spend millions on millions to counteract the impact of this healthy message. It’s David against Goliath, St. George against the Dragon. But the FDA is doing what its budget-restrained best to impact on a very serious public health problem.

Similarly, in an article that appeared in the New York Times in late March, the editorial columnist Nicholas Kristoff wrote a piece entitled “TV Lowers Birthrate (Seriously).” In it, Kristoff describes an amazingly positive effect of two reality TV shows on teen birth rates: “16 and Pregnant” and “Teen Mom.” In these shows, which are hits in the candid camera world of reality TV, the camera follows the experiences of real life teen moms. As Kristoff writes, “these shows remind youth viewers that babies cry and vomit, scream in the middle of the night, and poop with abandon.” This is a different message than the attractive image of teens getting it on with other teens in the sack with abandon and loving it.

According to an academic analysis done by professors at the University of Maryland and Wellesley College, tweets containing the words “birth control” surged by 23% one day after each episode and Google searches for “how to get birth control” also surged. According to their statistical analysis, the show has reduced teenage birth rates by 5.7% or 20,000 fewer teen births per year.

Kristoff goes on to write that the reduced birth rate seemed to be related primarily to the use of contraception, not increased abortion. After all, abortion rates did not increase in the same time period.

Notwithstanding how we may feel morally about teens using birth control in the first place, these reality TV shows seemed to have done the country a world of good, Since it is my contention and that of many other experts that mainstream media is a culprit here in glamorizing sex among teens, when the media itself creates shows that offer realistic descriptions of one of the greatest ill-effects of teen sexual behavior, namely teen pregnancy, we can both applaud and wonder what else the media might do to help kids.

Continue to Part 2.

Dr. George Drinka is a child and adolescent psychiatrist and the author of The Birth of Neurosis: Myth, Malady and the Victorians (Simon & Schuster). His new book, When the Media Is the Parent, is a culmination of his work with children, his scholarly study of works on the media and American cultural history, and his dedication to writing stories that reveal the humanity in us all.

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