Wednesday, July 23, 2014
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Kids are more likely to smoke in Philadelphia than in other big cities

f you're looking for a place to buy cigarettes, find a school; retailers will be nearby. Want to bum a smoke? Ask a white kid.

Kids are more likely to smoke in Philadelphia than in other big cities


If you’re looking for a place to buy cigarettes, find a school; retailers will be nearby. Want to bum a smoke? Ask a white kid.

Those are among the findings – well, they aren’t stated quite that way – of a new report that outlines the problems and challenges of youth smoking in Philadelphia.

After several years of sharp drops in the rate of smoking among city residents under 18, the pace of decline slowed early in the decade and appears to have plateaued the last few years, according to the analysis by the Philadelphia Department of Public Health.

That rate – 3.6 percent of high school students smoked on at least 20 of the previous 30 days – at first glance seems strikingly low, especially since it is half the national rate found by the same federal Youth Risk Behavior Survey. Yet even that low rate is the highest of the six major cities for which the department was able to get comparable data: New York, Chicago, San Diego, Boston, Seattle, and Philadelphia.

What’s strikingly high is the rate among white kids: 15.6 percent in Philadelphia vs. 9.4 percent in Boston, which had the second-highest rate of white youth smoking, and 3.5 percent in Seattle, which had the lowest.

The dramatically lower rate among black kids, by contrast, didn’t vary much from city to city: 1.2 percent in Philadelphia vs. 2.2 percent in San Diego (the highest) and 0.7 percent in New York (the lowest). Hispanic youth in Philadelphia smoked at a rate of 3.1 percent vs. 9.8 percent in Seattle (the highest) and 0.9 percent in Boston (the lowest).

Urban areas generally have lower rates of youth smoking than the nation as a whole because inner-city kids have less money to spend on cigarettes, Giridhar Mallya, who oversaw the Philadelphia report, said in an interview Wednesday. He said disposable income also helps explain why white kids smoke at higher rates just about everywhere. (Among adults here and across the nation, on the other hand, African Americans are more likely to smoke than whites.)

The report identified several factors that could be related to high youth smoking rates here.

A key one: Philadelphia has one of the highest rates of tobacco retailers per capita among large cities -- 27 for every 1,000 people ages 10 to 17, a total of 4,398 retailers.

More than 75 percent of retailers are located within two blocks of a school, and more than a third of kids surveyed said they purchased their own cigarettes, which the report said was the highest proportion among the large cities. Undercover investigations have found that take-out restaurants sell cigarettes to underage purchasers more than any other retail category, followed by laundromats, the report said. (The lowest rates of illegal sales were by convenience and grocery stores.)

Perhaps the most powerful tool that public health authorities have for reducing cigarette sales is raising the price through taxation. The average price per pack in Philadelphia last year was $6, according to the report, considerably less than some cities with lower smoking rates, such as Boston ($8.68) and New York ($9.21, and just raised to nearly $11).

New York City, with some of the lowest smoking rates in the United States, has long had an aggressive public health campaign to cut down on smoking. Taxing power also differs from state to state, allowing cities such as New York to have more control over retail prices.

Philadelphia City Council is currently considering an ordinance that would increase penalties on retailers who sell to underage buyers from $100 to $250.

“Children who smoke become adults who smoke,” Mayor Nutter said in a statement accompanying the release of the report, titled The Challenge of Youth Smoking in Philadelphia: Prevalence, Tobacco Access, and llegal Sales. “And smoking in Philadelphia leads to nearly 2,500 deaths and $800 million in productivity losses per year for the city. Now is the time to act.”

 
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About this blog

Check Up covers major health events in our region and offers everything from personal health advice to an expert look at health reform. Read about some of our bloggers here.

For Inquirer.com. Portions of this blog may also be found in the Inquirer's Sunday Health Section

Michael R. Cohen, R.Ph. President, Institute for Safe Medication Practices
Daniel R. Hoffman, Ph.D. President, Pharmaceutical Business Research Associates
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