Teenagers who lit up for the first time in the 1990s have helped swell the adult smoking rate in Minnesota to its highest level in eight years.

Last year 22 percent of Minnesota adults smoked cigarettes -- about 190,000 more than in 1998, when the rate hit a low of 18 percent, an analysis of federal survey data shows. The state's smoking rate has increased each year since then -- even as the nation's median smoking rate has stayed around 23 percent. Experts say Minnesota has seen a dramatic increase in smoking by young adults. In 2001, more than a third of 18-to 24-year-olds smoked, according to a new analysis of federal data by the Minnesota Health Department. Many young adults began smoking in the mid-to late-1990s, when Minnesota's teenage smoking rates rose to new highs, ranging from 30 to 40 percent, tobacco experts said. But some young adults also may be defying the long-held belief that just about anyone who smokes started before age 18. Some of them, experts say, could be lighting up for the first time later in life. "It shocks me," said Dr. Marc Manley, director of the tobacco research arm of Blue Cross and Blue Shield of Minnesota. "This means . . . we will have yet another generation that will grow up and be real sick from smoking." Minnesota's higher smoking rate caused the state to slip to No. 2 in the ranking of healthiest states released last week by UnitedHealth Foundation based in Minnetonka. (New Hampshire was first.) The adult smoking rate in Minnesota has hovered in the low 20 percent range since 1990, according to annual surveys sponsored by the federal Centers for Disease Control and Prevention (CDC). Tobacco experts can't explain why it dipped in 1998, though it may have been because of media attention on tobacco lawsuits in Minnesota and across the country. The increase in adult rates in recent years could be a return to normal, they said, not necessarily the start of an ominous trend. "The discouraging thing to me is that they are not going down," Manley said. While adult rates declined in the mid-1990s, teenage rates across the country were rising. In Minnesota they peaked in 1998 when 30 percent of ninth-graders and 41 percent of 12th-graders reported some smoking in the previous 30 days, according to surveys by the state Department of Children, Families and Learning. Those rates surpassed national rates. Advertising effect In that decade, health experts say, cigarette advertisements used the Marlboro man and the cartoon character Joe Camel, which was widely criticized as appealing to children. Tobacco industry officials said last week that their companies never targeted teenagers and always focused on adults who choose to smoke. Early in the 1990s, a public health campaign designed to discourage Minnesota teenagers from smoking virtually disappeared. The Health Department spent about $1.6 million a year for anti-smoking advertising and school-based education programs in the mid-1980s. But by 1994, state budget cuts pushed the funding down to one-eighth of its earlier levels, said Judith Hilton, a Health Department educator. That year, Will Monoski was 12 and experimenting with cigarettes, he said. Now 20 and still smoking, he said he doesn't recall being influenced by advertising, but he did want to emulate his very cool older brother who smoked. "I wanted to be cool, too," he said. Monoski of Minneapolis often smokes standing outside the Colades Salon, a beauty salon where he works just off the University of Minnesota campus. But he and two of his smoking co-workers said they plan to quit this Thursday, the day of the Great American Smokeout, a national promotion that encourages quitting. Experts say they believe that former teenagers such as Monoski and his friends are helping to swell the ranks of adult smokers. The smoking rate among that age group has been increasing since about 1992, said Linda Pederson, a senior staff fellow in the CDC's Office of Smoking and Health. "That group is getting older and their smoking rates are moving with them," she said. But it's not clear, she said, whether that group is creating a temporary bubble in the adult smoking rate. That will be answered in a few years when the current teenagers, who smoke at lower rates, reach adulthood, she said. The smoking rate for Minnesota high school students in 2001 ranged from 19 to 35 percent, depending on their age, according to the school survey conducted every three years. Public health officials credit the decline from 1998 partly to new anti-smoking campaigns launched in 1999 using money from the state's $300 million tobacco endowment. Complicating the picture of young adults is a new trend that has tobacco experts scratching their heads. Research has shown that, historically, 90 percent of all smokers started as teenagers. However, young adults today don't always fit that pattern. Dr. Edward Ehlinger, a professor of epidemiology at the University of Minnesota who studies college-age smokers, said his surveys show that a fourth of the smoking students at the University of Minnesota started after age 18. "We don't know what happens to those folks, if they become long-term smokers or not," he said. Judy Kim, 23, a neurosciences graduate student at the university, said she smoked her first cigarette while she was a college student in Korea. "I picked it up off the floor -- an unsmoked cigarette," she said last week while she was having a beer -- and smoking -- with friends at a bar near campus. "I knew I'd regret it." When she transferred to a college in Iowa, she and her friends liked to take smoke breaks while they studied, she said. Now, as a neurosciences student, she appreciates how nicotine works its power on the brain. But she isn't worried about quitting -- yet. "My cutoff point is definitely [age] 30," she said. "And hopefully before then." Asking why So why do 18-to 24-year-olds start at all? To prove their independence, to fit in, because it goes hand-in-hand with drinking, because they believe they are invincible and are not addicted, Ehlinger said. He also believes that cigarette advertising is aimed at those just old enough to buy cigarettes legally. In most states, including Minnesota, that's 18. Some tobacco companies say their advertising is aimed at those 21 and older who are better able to make an informed decisions about smoking. "Our marketing efforts are focused on adults smokers, 21 years and older," said Billy Apshaw, manager of media programs for Philip Morris U.S.A., the maker of Marlboro. Meanwhile, public health officials are scrambling to catch up. Blue Cross, the state Health Department and the Minnesota Partnership for Action Against Tobacco (MPAAT) are conducting a survey of adult Minnesota smokers and plan to pay special attention to the youngest smokers. When completed, the survey should tell more about young people who smoke -- their race, sex, whether they are students and what got them started. Armed with that information, anti-smoking groups may try to adjust their message about avoiding smoking and trying to quit.

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