year old boy, for example, hanged himself inside his house and when found he was already unconscious and his tongue protruding. He later explained that he wanted to “try” out hanging. He said that he did not want to die, although he knew he was risking death. Such cases of imitative suicide attempts by boys as young as five and six have been reported recently from Truk. Several cases of young adolescent suicide deaths recently in Micronesia were evidently the outcome of such experiments. Thus as suicide grows more frequent in these communities the idea itself acquires a certain familiarity if not fascination to young men, and the lethality of the act seems to be trivialized. Especially among some younger boys, the suicide acts appear to have acquired an experimental almost recreational element.
There is something very chilling about this passage. Suicide isn’t supposed to be trivialized like this. But the truly chilling thing about it is how familiar it all seems. Here we have a contagious epidemic of self destruction, engaged in by youth in the spirit of experimentation, imitation, and rebellion. Here we have a mindless action that somehow, among teenagers, has become an important form of self expression. In a strange way, the Micronesian teen suicide epidemic sounds an awful lot like the epidemic of teenage smoking in the West.
1.
Teenage smoking is one of the great, baffling phenomena of modern life. No one really knows how to fight it, or even, for that matter, what it is. The principal assumption of the anti smoking movement has been that tobacco companies persuade teens to smoke by lying to them, by making smoking sound a lot more desirable and a lot less harmful than it really is. To address that problem, then, we’ve restricted and policed cigarette advertising, so it’s a lot harder for tobacco companies to lie. We’ve raised the price of cigarettes and enforced the law against selling tobacco to minors, to try to make it much harder for teens to buy cigarettes. And we’ve run extensive public health campaigns on television and radio and in magazines to try to educate teens about the dangers of smoking.
It has become fairly obvious, however, that this approach isn’t very effective. Why do we think, for example, that the key to fighting smoking is educating people about the risks of cigarettes? Harvard University economist W. Kip Viscusi recently asked a group of smokers to guess how many years of life, on average, smoking from the age of twenty one onward would cost them. They guessed nine years. The real answer is somewhere around six or seven. Smokers aren’t smokers because they underestimate the risks of smoking. They smoke even though they overestimate the risk of smoking. At the same time, it is not clear how effective it is to have adults tell teenagers that they shouldn’t smoke. As any parent of a teenage child will tell you, the essential contrariness of adolescents suggests that the more adults inveigh against smoking and lecture teenagers about its dangers, the more teens, paradoxically, will want to try it. Sure enough, if you look at smoking trends over the past decade or so, that is exactly what has happened. The anti smoking movement has never been louder or more prominent. Yet all signs suggest that among the young the anti smoking message is backfiring. Between 1993 and 1997, the number of college students who smoke jumped from 22.3 percent to 28.5 percent. Between 1991 and 1997, the number of high school students who smoke jumped 32 percent. Since 1988, in fact, the total number of teen smokers in the United States has risen an extraordinary 73 percent. There are few public health programs in recent years that have fallen as short of their mission as the war on smoking.
The lesson here is not that we should give up trying to fight cigarettes. The point is simply that the way we have tended to think about the causes of smoking doesn’t make a lot of sense. That’s why the epidemic of suicide in Micronesia is so interesting and potentially relevant to the smoking problem. It gives us another way of trying to come to terms with youth smoking. What if smoking, instead of following the rational principles of the marketplace, follows the same kind of mysterious and complex social rules and rituals that govern teen suicide? If smoking really is an epidemic like Micronesian suicide, how does that change the way we ought to fight the