Last year a group of African-American religious leaders blamed Big Tobacco for the increase in cigarette smoking among black youth. They pointed to advertisements such as the hip-hop Joe Camel displayed in their neighborhoods and complained of what they saw as an industrywide plot to seduce black youth into the deadly world of cigarettes. Their concern, it turns out, was on the money: Last week, a study by the Centers for Disease Control and Prevention found that there has been an 80 percent increase in the number of black high school students smoking since 1991.
Although teen smoking is on the rise not only in the African-American community -- the study also found a 30 percent increase among whites and Hispanics -- the new figures dismantle what had been a public health success story. For years, African-American teens were not lighting up in large numbers, and, in fact, had been decreasing their usage.
Salon spoke with Dr. Joycelyn Elders, the controversial former surgeon general -- who was kicked out of the Clinton administration for advocating masturbation as the safest form of sex -- about the current state of health education, the .role advertising plays in luring smokers and why she still supports the president.
Given the fact that the dangers of smoking are widely known, why has cigarette smoking increased among high school students?
It's our fault. We're fussing and being mad at the tobacco companies, but we have not educated our children -- we've left them susceptible. And the tobacco industry is the one doing the educating about smoking -- not us.
Tobacco companies lure teens into what I call the "5-S" club by showing images of people who are Slim, Sexy, Sophisticated, Sociable and Successful. Isn't that what all young people want to be?
Do you think the hip-hop Joe Camel ads influence young black teens?
Without question I feel that the hip-hop groups and Joe Camel ads influence what goes on in African-American population.
Why are teens so influenced by these ads?
I don't think it's only teens who are so easily influenced. We are too. We know that if you haven't started smoking by the time that you're 19, there's a 90 percent chance you never will. I think that cigarette companies know that if they let me get old and decrepit, they aren't going to induce me to smoke, so why work on me? It's far better to work on young people who are more susceptible and far more likely to become addicted.
How would you propose educating children and teens about the dangers of smoking?
You have to use the same marketing tactics that the tobacco companies use -- ads -- and target not only kids, but grandma and grandpa and ma and aunts and uncles and the whole community to make them understand the responsibility they have to prevent smoking. We've got to get very aggressive and begin to have a comprehensive health education program as a part of our school system so we can educate all children, from kindergarten to 12th grade.
Should education be tailored to specific communities?
Yes. With the African-American community I would use the churches an awful lot more, use the radio stations that they listen to and use athletes they respect to get out the anti-smoking messages.
The African-American community must be devastated that there has been such an increase in smoking among black teens.
I'm not sure that the African-American community is that upset. If you look at everything -- at what's happening with teenagers and AIDS, with teenage pregnancy, tuberculosis and all of those sexually transmitted diseases -- as far as the African-American community can see, these things kill more people than cigarette smoke. They aren't thinking of the long term.
Do you think that teens believe that there's no real danger from smoking, that they are somehow invincible?
We went around for a while beating our chests thinking that smoking was going down and now we find that it's rising at a very rapid rate. Somewhere along the way we've dropped the ball. We've all accepted the fact that smoking causes cancer, but our young people do not think of things 10, 20, 30 years down the line. They don't even think about engaging in high-risk sexual behavior or the possibility of having a baby within 9 months. How can we expect they're going to comprehend that smoking will give them cancer in 30 years?
I think they start smoking and feel that they can quit whenever they feel like it. I don't think they plan to smoke forever. In fact, during my short stay as surgeon general a book came out on youth and smoking and I think that that's what the study said: If you really survey teens, most of them feel that they can quit whenever they want to but if you go back a year later and look at them, 90 percent of them have not, but they all say that they'd like to. Tobacco is addictive and we're not marketing the information that we have correctly.
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The CDC study looked at 1991 to 1997 -- basically the Clinton years. Do you think the Clinton's administration is doing enough to counter teen smoking?
I think that we're seeing a new generation of young people that have not been educated. And I do not think that it's related to the Clinton years.
Do you think something will change in the future?
I think people will finally realize they we've got to do something. We can't afford to see children killing children, we can't afford to see children having children, we can't afford to see children involved with drugs -- and cigarettes to me is a drug -- or drinking. We can't jail ourselves out of this mess. We've got to start educating.
What do you think about the scandals dogging President Clinton?
I support the president and I feel that we've gotten all bent out of shape over this. I feel the president has been a good president. I don't think the other issues -- I don't think that his sex life is any of my business. I consider that Hillary's business and she takes care of it if she wants.
Do you think Clinton is a hypocrite? Are his conservative policies on sex -- which led to your dismissal -- contradicting with his own behavior?
We all have a certain amount of hypocrisy. He is doing what we elected him to do and that is to be a good president. Why should we get bent out of shape about things that really only involve the people involved?
Critics might say that the president may not be practicing what he is preaching. Here he had conservative policies on sex education, and then he's reportedly involved with Monica Lewinsky...
Some of his policies are maybe ones that the president felt he could get through the Congress and may not necessarily reflect exactly what he feels. I feel that the president is a very compassionate man who wants the best for all children.
So, you think it's OK for Clinton to have such a discrepancy in his personal and private life as long as he has a vision for the children?
I guess I don't even get concerned about his personal life. I want his vision to be clear and I think it is. I feel that he is trying to move this country forward as best as he knows how.
What do you think about the Paula Jones case being thrown out?
I think there were Clinton haters from Arkansas who were supplying junk to Washington. I am very pleased that the Paula Jones case was thrown out. I never felt she had very much of a case. If she really wanted to do something about it, she should have done something about it in 1991 or whenever it happened. And since she didn't do anything about it then, why is she bringing it up now? She is bringing it up because there are people pushing her and paying her bills, and they aren't concerned about Paula Jones -- they are using her as a tool to fight Bill Clinton.
Do you think there is "a vast right-wing conspiracy" as Hillary Clinton has suggested?
I think that the right wing has worked overtime and spent a lot of time and money doing anything they feel that they can do to attack Bill Clinton. They attacked me -- not because they cared about Joycelyn Elders -- but because I could be used as a tool to attack Bill Clinton.
How would you grade Clinton's performance as president?
I would give him a very high rating as president. I have been very impressed with him. I feel that he has done a lot for this country economically and is trying to move some social issues forward. We failed on health care, but I feel that the reasons we failed are multiple and were not all necessarily his.
So you are not upset anymore about your dismissal?
I didn't stay upset but two or three days. As far as I am concerned, in politics you have to do what you feel you need to do to move your agenda forward. And I was not what the president thought he needed at the time.
When you were in the White House, did you ever see anything that would indicate that he was sexually out of control?
I was never around the White House that much. I saw him at times, but it was always in big meetings or at social events.
So you never saw him chasing anyone at these crowded dinners?
No, I didn't see him pulling anyone into closets [laughs]. No one is that out of control. Let's get real.