See more of the story

The images in the TV commercial are startling — elementary- and middle-school students lighting up cigarettes on a school bus, quietly smoking alone in their seats. A fleet of yellow school buses is shown, which represents the 77,000 Minnesota middle- and high-school students who use tobacco products.

The StillAProblem campaign, sponsored by ClearWay Minnesota, has another commercial, this one showing teens on a haunted roller-coaster ride that reveals the physical transformations smoking can cause. The commercials reinforce the idea that many of today's young people are not heeding the warnings about the dangers of smoking.

"We have received feedback on the school-bus ad from some who expressed concern about the fact we are showing kids smoking, but it is supposed to be a little shocking," said Michael Sheldon, senior communications manager for ClearWay Minnesota, a nonprofit organization that began in 1998 with funding provided by the state's tobacco-company settlement.

The time to capture the attention of young people and parents is during the elementary- and middle-school years. About 90 percent of smokers pick up the habit by age 18, Sheldon said.

A January 2013 report to the Minnesota Legislature on tobacco use reveals positive steps as well as problem areas regarding youth tobacco-use prevention. While 25.8 percent of students in grades nine to 12 use tobacco, with cigarettes being the most common, high school tobacco use fell by 33 percent from 2000 to 2011 and middle-school use fell by 56 percent (to 5.6 percent of middle-schoolers). The report came from the Minnesota Department of Health.

The object of desire

What continues to attract the attention of young smokers are tobacco products such as "snus" (small snuff packets), flavored cigars, cigarillos (little cigars) that come in flavors such as peach, strawberry and chocolate, as well as menthol cigarettes, which Chris Tholkes, of the state Department of Health, said is a source of concern.

"Menthol masks the harshness of the smoke and goes down easier, which makes it more comfortable," she said.

Because it is illegal for anyone under 18 to buy tobacco products of any kind, kids often will turn to older friends, siblings and, in some cases, parents.

"For some families, it's the norm. Several years ago, I taught a youth diversion program and it was not uncommon to hear from kids that they would get a carton of cigarettes in their Christmas stockings," Tholkes said.

Rolf Carlsen, principal at Oxbow Creek Elementary School in Champlin, said talking to the school's kindergarten through fifth-grade students about smoking can be tricky, especially if one or both parents smoke. "We tell them their parents aren't breaking the law," he said.

At Oxbow, anti-smoking messages are directed primarily to fifth-graders through their participation in DARE (Drug Abuse Resistance Education), a national curriculum focused on substance abuse prevention and safety. Although he does not consider smoking to be a problem at the grade school, Carlsen said, when a situation has arisen in the past, the younger student typically has an older sibling who encourages it.

Dissuading young smokers

While ClearWay Minnesota concentrates primarily on adult smoking cessation rather than on youth prevention programs, Sheldon said the StillAProblem television commercials — along with additional resource information on the website — "can provide a good launching point for parents to discuss smoking and tobacco use with kids."

Focusing on policy efforts that have a wide reach is part of a statewide health improvement initiative from the state Department of Health, which includes $3.2 million in government funding from the Legislature to provide grant money to local communities for programs including tobacco prevention. However, sometimes the bottom line for changing the habits of young smokers is found in their own wallets.

"For every 10 percent increase in the price of cigarettes, we see a 6.5 percent drop in youth smoking," Tholkes said, adding that the proposed tobacco tax in Gov. Mark Dayton's budget could further discourage youths from spending money on tobacco products.

"Education will only get you so far," she said. "As we all know, if it was only as simple as putting a warning sticker on a pack of cigarettes, the smoking rate would be zero."

Julie Pfitzinger is a West St. Paul freelance writer.

RESOURCES

ClearWay Minnesota: Resources and adult cessation information at www.clearwaymn.org.

Still a Problem: Television commercials, statistics and resources at www.stillaproblem.com.

Minnesota Department of Health: www.health.state.mn.us. Click on "Prevention and Healthy Living."