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    Fighting Against a Mass Murderer

    'I'm Hurting Myself'
    WebMD Health News
    Reviewed by Craig H. Kliger, MD

    Feb. 26, 2001 -- Michelle Globerson started smoking when she was just 15 years old. Now 45, she's quit smoking four times, each time cold turkey, but never for good.

    Recently, she's been seeing more and more public service announcements on TV, including one spot that calls smoking "puking (and) disgusting." She agrees. But she's still not ready to give up her pack-a-day habit.

    "I know it's wrong -- I'm hurting myself," says Globerson, a supervisor for a pool building company in Mesa, Ariz. "Something is going to make me want to quit. I just don't know what it will be."

    She has plenty of company. Despite a decline in U.S. smoking rates since the mid-1960s, tobacco use among women remains stubbornly high.

    At first glance, the nationwide numbers seem to favor females. Just 20.9% of adult women smoke, compared with 24.2% of men, according to the latest CDC data. But the data mask a remarkable drop of nearly 47% in male smoking rates between 1965 and 1995, compared to a more modest decline of 35% for women.

    More worrisome is the increase in lung cancer cases. Among women, they've more than doubled since 1973, according to the American Lung Association. Lung cancer mortality fell by 3.2% for men between 1992 and 1997, but among women the rate was essentially unchanged.

    There's also concern about teens. While youth smoking rates appear to have steadied after years of increases, an important new study raises serious questions about the effectiveness of school-based programs, a mainstay of teen education efforts.

    The study, by researchers at the Fred Hutchinson Cancer Research Center in Seattle, appeared in the December 2000 issue of the Journal of the National Cancer Institute. It surveyed smoking rates among 8,400 students in Washington state, half of whom had been exposed to an intensive, grade 3-to-12 program.

    The program was based on the popular "social influences" approach, which teaches kids how to resist TV ads and peer pressure through media literacy classes, role-playing, and other behavioral exercises.

    The results were surprising: Researchers found "no significant difference" in tobacco use between students who had gone through the program and those who hadn't; the smoking rate among 12thgrade girls who took antismoking classes, for example, was 24.4%, compared with 24.7% for those who didn't.

    "It was disappointing, because the social influences approach has been such an attractive one," says Arthur V. Peterson Jr., PhD, a Hutchinson researcher and professor of biostatistics at the University of Washington. "We had high hopes."

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