is to encourage underage youth. in fact, nearly 90% of smokers start by age 18. more than 80% of underage smokers choose brands from the top three most heavily advertised. you will hear in this report, a major conclusion that advertising and promotional activities by tobacco companies cause -- cause -- the onset and contin ya continuation of smoking among adolescents and young adults. the more young people are exposed to marketing and promotional activities the more likely they are to smoke. far too many kids still see smoking images and messages every day that normalize this dependence. for example in 2010, nearly 1/3 of the top grossing movies produced for children contained, contained images of smoking. just about half of our states continue to allow smoking in

public places. images and messages normalize tobacco dependence in magazines, internet and retail stores. in short, kids see smoking in the movies they watch, the video games they play, the web sites they visit, and in the communities where they live. from 1997 to 2003, youth smoking fell rapidly. but since that time, the rate of decline has slowed. in fact, there would be 3 million fewer smokers today if we as a society had sustained the success and declines seen between '97 and '2003. of great concern we are seeing youth consume tobacco products. smokeless tobacco, hookah and small cigars. in total we can document 3.6 million youth cigarette smokers and 1.7 million adolescents

using noncigarette products such as smokeless tobacco products and little cigars. moreover, many young people are concurrently using multiple types of tobacco. in fact, among those who use tobacco, more than half of high school males and nearly a third of high school females use more than one type of tobacco product, whether it be cigarettes. cigars, smokeless tobacco or some other form. this surgeon general's report not only provide powerful detail, the factors that lead to youth -- use. but also identifies proven effective strategies that can advance prevention. we at department of human health services, commit to strengthening proven effective strategies as part of a comprehensive, coordinated national approach. in november 2010, we were proud to release ending the tobacco

epidemic. a tobacco controlled plan for the united states from the department of health and human services. the plan sets forth specific actions where the department can implement progress, build on recent legislative milestones, respond to the changing market for the tobacco products, and support robust tobacco control programs throughout the country. we have ample evidence that these comprehensive, multicomponent interventions work. such programs more than pay for themselves in terms of lives saved, and dollars saved. the current problem is that we have not yet fully applied the evidence based tools that would end this epidemic. between 2005 and 2010, 20 states had declines in smoking prevalence, 20% or more. that's encouraging. but we need to accelerate the declines in each and every state. and sustain them to benefit all of our kids for the future. until we end the tobacco

epidemic even more young people will become addicted, even more will die, and even more families will be left behind, deaf stat d -- devastated by the loss of loved ones. thank you so much for being here today. we must redouble our commitment to accelerating comprehensive programs, making cessation services accessible and affordable, creating an environment that denormalizes this dependence, and most of all, give our young people a fighting chance to be healthy and tobacco-free. thank you very, very much for being here. i am pleased now to introduce surgeon general dr. regina benjamin. [ applause ]

>> good morning. it's such a nice turn out. thank you all for being so interested in an important public health issue. thank you, dr. koh for sharing with us the department's and administration's commitment to tobacco control. i would lock ike to say a very special thank you to secretary sebelius for her strong leadership on this most important public health issue. she has made it a top priority. i would also look to just recognize my tobacco-free advocates, the young students and group that i have been working with, through the years, north carolina, virginia. why don't you guys stand up? there are some others. and also, the others who are wang web stream this. you know the -- 2012 surgeon

generals report preventing tobacco use among youth and young adults is a result of contributions of more than 130 health experts. so i would look to recognize the editor whose are with us today, dr. cheryl perry, dr. melissa stigler, dr. frank chipluca who are here and they'll be here to help with questions and answers if you get into too detailed things. also i understand, i think dr. woody kessler is here to represent dr. c everett coop. i would like to thank my medical school mentor, dr. david satcher, former surgeon general, and all former surgeon generals for their work on tobacco. every surgeon general since 1964 has weighed in on the issue of tobacco. and every one has called for an immediate action to solve this problem. today's release is the 31st

surgeon general's report on tobacco, preventing tobacco use among youth and young adults. it remind us once again that the burd in of tobacco puts a burden on society. and the report challenges us to end the epidemic of smoking among young people. and the numbers in this report are shocking. you have heard some of them earlier. they're worth repeating. every day, 1,200 americans die from smoking. and each of those people are being replaced by two young smokers. almost 90% of those replacement smokers smoke their first cigarette before they're 18. despite reductions in tobacco use in the past decade, today more than 600,000 middle school students smoke. stand 3 million high school students smoke cigarettes. also, nearly one in three young adults, between the ages of 1 and 26, smoke.

and this is the higher -- rate than any other age group. so this is a serious public health issue. one of the most serious findings in the report is about nicotine addiction and the younger they begin smoking the more likely they are to become addicted. every year 1.4 million youth under the age of 18 try their first cigarette. and many of them end up being lifelong smokers. cigarettes are designed for addiction. and nicotine is the key chemical compound that causes the powerful addicting effects in cigarettes. added ingredients and design features make them more attractive and addictive, many ingredients, sugar, moisture enhancers, when they're add they'd reduce the harshness and improve the taste and the consumer appeal. chemical ingredients such as

ammonia, convert nicotine into what we call free nicotine that more quickly crosses the blood/brain barrier. and ventilation holes and filters, make smoking easier to inhale into the lungs and convert the nicotine. all of these design features work together to enhanceat -- the addictive kick and pleasures smokers feel. adolescents bodies are more easily addicted than adults. this helps explain why 1,000 teenagers become daily smokers. and three out of four high school students continue to smoke. well into adulthood. even if they have attempted to quit in a few years. and there are also other tobacco products that youth find appeali appealing. some of the cigarette sized cigars include fruit-flavored and candy-flavored things like, strawberry and grape.

some of the latest smokeless tobacco products are spitless. and others dissolve look mints. part of their appeal is that they can be used at school or at home, in front of mom and dad, even, even, you know so they can't be detected. and they may not know their kids are using them. understand that these products cause nicotine addiction. this report also highlights some of the health effects. in addition to the increase risk for serious chronic diseases like cancer and heart disease and emphysema, there is a, an immediate damage to the heart and to the lungs. studies show that many young smokers have early cardiovascular damage particularly early changes in the aorta. that puts them at higher risk for aortic dissection and they tend to die very young.

smoking in adolescence slows development of lung function and teens who smoke can end up as adults with lungs that never reach their full functioning capacity. another finding in this report is that marketing and advertising to, of tobacco products, to young people, have the been very successful. in this report, scientists use studies. the more the youth is exposed to marketing and advertisement, the more likely they are to start and maintain smoking. and in the united states alone, more than $1 million an hour, over $27 million a day, is spent on targeting messages and images to portray smoking as an acceptable and appealing activity. we know that prevention is the key. 99% of smokers begin smoking before the age of 25. so we want to prevent our next

generation from ever starting to smoke. if we can just get them to remain smoke-free, until they're 26, less than 1% of them will ever start. we know it works. we know that when we enact smoke-free policies we reduce exposure to second-hand smoke. prompt smokers to quit. change social norms and support healthy decisions. we know that when we increase the price of tobacco, smoking rates decline among youth. we also know that when we educate the public, with aggressive media campaigns, we inform them of the risk, encourage tobacco users to quit and prevent youth from starting to smoke. and science tells us that that sustained multicomponent programs prevent young people from starting to use tobacco. we saw this approach in new york city. when they cut their -- youth smoking in half in as little as six years. we have implemented the types of

comprehensive tobacco programs in the past and we saw a steady decline in the rate of youth use between 1997 and 2003. had we maintained that course, we could have prevented 3 million smokers. we need new bring back that level of commitment. bring it back to the program tuesday. it's time for us to really end the single most preventible cause of death in this nation. as you can see, we are committed to say, we can make our -- make our next generation, tobacco-free. so i have tried to describe to you some of the many findings in this 2012,000 surge-- 2012 surg general's report. the final report is 900 pages long and really written for a scientific audience. but it really is important that americans and all of americans understand that we can end this tobacco epidemic by preventing youth from ever starting to use

it. so we have developed a consumer booklet that you can see that is in your packet. and it's written in plain language, good graphics, entitled surgeon general's report, preventing tobacco use among youth and young adults. we can make the next generation tobacco free. and i would look to say thanks to the centers for disease control and preventions office of smoking health. because they have -- helped us with a new project. so i would look to formally and officially launch the surgeon generals video challenge. this is a competition to engage young people in developing original videos that feature one or more of the surgeon general's report findings. contestants are encouraged to use this consumer piece that i just showed you, as a guide to writing their health messages in their videos. and the contest will have -- two age categories. with english and spanish.

age 14-18, and age 18-24. and you can, join as an individual, or as groups, as teams, such as schools. and after you submit your video, it will be screened, and after it is screened, eligible videos will be put up on cdc's youtube channel for public voting. then the top then of those will be judged by an expert panel. there is also a $5,000 grand prize. and several $500 runner-ups. so we are looking forward to having some good videos and, and in this competition. more information can be found at surgeongeneral.gov. so i thought i would now show you my video that -- that is also called "psa" or public service announcement. so -- >> at 12 i smoked my first cigarette. >> at 15 i was addicted.

>> by 40 i have lung disease. >> at 50, i'll die of a heart attack. >> cigarette smokemediate damag health problems even death. those who quit or die are being replaced by a new generation of smokers. i'm dr. regina benjamin, surgeon general, go to cdc.gov. learn how to make our next generation tobacco free. [ applause ] >> so i would look to ask dr. cheryl perry to join dr. koh and i. we will be happy to take your questions. i understand we have time for

only several questions. but we would be delighted to take some now. >> yes. my question is for the surgeon general. what role do you see as primary care providers, primary care physicians playing in all of this? >> i think primary care physicians and any physicians are well respected by their patients and they listen to their patients. i ask patients to talk to their doctor. and as far as doctors we need to always talk to our patients about smoking and, ways to quit smoking. particularly in the primary care arena when we are dealing with adolescents and this age group. we can have very strong effect there. >> other questions from the audience? going once. okay. thank you very much for being here. >> thank you. >> thank you.

up next on c-span 3 a house oversight committee hearing on fraud in the food stamp program. then discussion on the effect of negative political ads. and later, a hearing on the 2013 budget for the u.s. agency for international development. starting april 1st, see the winners in this year's c-span student-cam video documentary on the theme the constitution and you. sthoeg whi we'll air the top 27 videos.

mornings at 6:50 eastern on c-span and meet the students who created them during "washington journal" each day. for a preview check studentcam.org. congratulations to everyone who participated in this year's competition. >> two live congressional hearings wednesday morning on c-span 3 to tell you about. at 9:30 a.m. eastern the house oversight committee looks at the european debt crisis. both federal reserve chairman, benjamin bernanke and treasury secretary tim geithner testify. when that wraps up, the house budget committee, beginning consideration of the republican budget proposal for next year. expect to bring you the house budget markup at 12:30 p.m. eastern. >> the news service reported earlier this year that it found millions of dollars of fraud in the food stamp program.

the report said hundred of retaller banned from the program continued accepting food stamps. some in exchange for beer, cigarettes and cash. earlier this month, the house oversight committee held a hearing on the issue. this is about an hour and a half. >> the committee will come to order. the oversight committee exists to secure two fundamental principles, first, americans have a right to know that the money washington takes from them is well spent. and second, americans deserve an efficient, effective government that works for them. our duty on the oversight and government reform committee ties protect these rights. our solemn responsibility is to hold government accountable to taxpayers, because taxpayers have a right to know what they get from their government. we will work tirelessly in partnership with citizen watch dogs to deliver the facts to the american people and bring genuine reform to the federal

bureaucracy. i'll now recognize for an opening statement and pursuant to the admission statement be asked that the video be played since it reflects the watch dog in question. >> food stamp fraud is costing americans millions in taxpayer money. >> across the country in new york, l.a., miami, detroit and here in san diego. >> in the past five years alone, the usda permanently disqualified 4,600 retailers. >> 24 phoenix area stores permanently disqualified. >> san diego retailers ripping off the federal government. >> 23 retailers in the palm beach store. >> like many we found is banned from accepting food stamps and approved to accept them. >> investigators poured over the records. >> 1,500 stores across the country on both of them. awe all. sda says 99% of the time it's for illegal trafficking. >> a retailer will overcharge a

customer. >> they want to trade their benefits for cash or banned merchandise like alcohol. >> trading booze for taxpayer money. >> the store keeps $50. the card holder gets $50. all taxpayer money. >> what does this back door ultimately cost us taxpayers? >> according to usda record, $330 million since 2008. >> america deserves better. just yesterday one of our witnesses penned an depicted the improvement in the program proudly stating how much better it was. it is not for us today to question whether or not the program has improved, the question is -- in a day in which in a moment's notice in a few key strokes i can look at a storefront anywhere in america, find out who, what, where, owns

that or in this case, the scripps howard could do a few public record searches available to the department of agriculture and find out what they were doing wrong from open source. we need to do er the hearing today is about children. the hearing today is about families. ultimately the food about provi nutrition to peopleneed. 42 million people rely on the food stamp program. a few misuse the program. our hearing today is not aboutd desperation for drugs, alcohol, or just spending se food stamps. it's about america's responsibility, this administration, and this congress' responsibility to make sure that the money or the benefit of the money gets to the people who are supposed to get it i is not to buy alcohol,

cigarettes or drugs. a relatively few storefronts around america represent a considerable amount of fraud. understand that a small amount of stores, does not mean there is a small amount of fraud. people who want to use or misuse i should say the resources provided to them by the taxpayer in the way of food stamps. seek out stores who will cheat. it is not an accident that you find out some where in the neighborhood a, an entity will trade you $100 in food stamps for $50 in cash so you can go score. the score is bad enough. let's understand, some where there is a family that relied on food that instead got nothing. these companies and these individuals behind these companies need to be punished on a consistent basis.

if in fact, they are suspended. it needs to be for a period of time with an understanding of whether or not they are ever going to be able to sell again. if they are permanently excluded, then in fact, permanent needs to mean permanent. more importantly, in this day and age of ability to research. if you only have 100 people to, to track this huge all. potential waste, one can make the other 99 more effective. the scandal we are looking at today is important because we know that 100 people working for the secretary, in fact, found people who were stealing from the taxpayers and stealing from families who need that food and need that benefit. one of those 100 assigned to do what whistle blowers have done for us, in fact, could have prevented many of these stores from being back in business.

it's that simple. we will hear today, as we often do if we only had more resources. this committee has no more resources to provide. in fact you are going to have to do more for less. more oversight. more accountability. with less money available for that. and more need by people in, on the food stamp program. we are going to hear testimony on both sides saying we are doing a better job. we are going to hear people sawing you are not doing well enough. both can be true. america in fact expects both to be true. continuous improvement, but in fact, never satisfied that we have done enough. with that i recognize the ranking member for his opening state. >> thank you. i welcome today's opportunity to conduct oversight of the program which is one, has one of the

most vital missions of any government program, which ties prevent abject hunger and homes all across america. i am so glad that you said this hearing amupg othong other thint children. and thank you for inviting ms. jennifer hatcher. since this hearing is about store owners, i thought it was appropriate to invite them. ms. hatcher's organization represents 26,000 supermarkets and food stores across the country that implement the program on a daily basis. also want to thank you for allowing our minority witness to appear, on the first panel with everyone else, you did not have to do that but you did. and we are in deed grateful. let me start by emphasizing a critical point. nearly half of all the ben fish ae -- beneficiaries of the program

are poor, hungry children. serving 46 million americans with incomes at or below 130% of the poverty level. according to usda, 47% are under 18 years old. the program also serves millions of people who are elderly or have disabilities. has never been more critical than it is today. 2008 financial crisis drove more americans into poverty than any other time since we started tracking this data. the collapse of wall street and the evisceration of trillions of dollars in household savings forced millions of americans to turn to this critical safety net. and it has been there for them. while the need for the s.n.a.p. program is at an all time high.

fraud is at an all tomb lime lo. one of the most efficiently run program with one of the lowest fraud rates. fraud has declined from 4 cents of every dollar in 1993 to 1 cent of every dollar expended to day. but i agree, that that is not good enough. the majority appears to be basing today's hearing on a recent press stories about a certain store owners who had been disqualified from the program but allegedly regain entry in some way. although this would be problematic if true we have not seen evidence to support allegations there is a pervasive weakness in the program or the magnitude of fraud in the program may be much greater than initially reported. in fact, today, i will hear just the