CHICAGO (AP) - The surgeon general is calling upon states to use more money from their multimillion-dollar tobacco settlements on anti-smoking campaigns, citing a ``failure to implement proven strategies.''

In a report released Wednesday, Surgeon General David Satcher said ``enormous'' settlements are available to pay for major new anti-tobacco efforts. ``I think states are missing a tremendous opportunity,'' Satcher said as he released his ``Reducing Tobacco Use'' report at the 11th World Conference on Tobacco in Chicago. He said he would like to see states use 20 to 25 percent of the settlement money for anti-smoking campaigns. So far, states plan to spend about 10 percent of tobacco companies' first 25-year payment - $8 billion in all - on smoking prevention programs, according to a report issued last month by the National Conference of State Legislatures. More than half the money has been earmarked for health care and services for the working poor. Satcher joined conference officials in calling for stepped up anti-smoking measures, including higher taxes on cigarettes and campaigns aimed at young people. Among other things, the nation's top doctor called for greater access to pharmaceutical drugs that help treat nicotine addiction; more regulation of tobacco advertising, especially ads aimed at young people; and clean air regulations to protect against secondhand smoke. ``Our lack of greater progress in tobacco control is more the result of failure to implement proven strategies than it is the lack of knowledge about what to do,'' Satcher said. Such strategies could help the federal government reach its health goals, part of a plan called Healthy People 2010. The goals include cutting Americans' tobacco use in half. Federal officials estimate that 400,000 Americans die each year from tobacco-related illnesses. They also estimate that 1 million young people start smoking each year. Some states have already begun using funds obtained from settlements from tobacco companies. In the last two years, for example, Florida has used millions of tobacco dollars to wage a TV ad campaign against tobacco companies. State officials say the irreverent ads - including one that depicts a tobacco executive receiving an Oscar-like award in hell for causing the most deaths - have helped drop smoking rates among young people. Ursula Bauer, a Florida health department epidemiologist, said statewide surveys in 1998, 1999 and this year found that 49,000 middle and high school students have quit smoking since the pilot program began. The survey results were published in Wednesday's Journal of the American Medical Association. Bauer said she felt confident in attributing the drop to the state's education program because, nationally, teen smoking rates continue to rise. However, she said an agreement signed by other states - part of a group settlement with tobacco companies - bans those states from running attack ads that ``vilify'' tobacco executives. ``We have more flexibility to present a hard-hitting message,'' Bauer said. The 1998 settlements call for tobacco companies to pay more than $200 billion to the nation's states over 25 years.

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