While Kentucky school and tobacco prevention advocates struggle to solve the problem of youth smoking, states like Florida and California have created a huge dent in the number of young smokers.

In 1998 Florida launched a youth-led statewide mass media campaign that included television and billboard ads, hiring school tobacco counselors, developing tobacco education courses and holding rallies with T-shirt giveaways and other gimmicks. The initiative was financed with part of a $13 billion settlement that Florida had with tobacco companies.

It paid off. Florida youth smoking rates were lowered by 60 percent among middle school students and 42.7 percent in high schools.

"We are seeing that these campaigns can be extremely effective for kids," said Patrick Reynolds, founder and director of the Foundation for a Smokefree America. "It's a shame that Kentucky ranks among the last in tobacco funding. It's a real betrayal of kids."

Kentucky has $2.7 million earmarked toward tobacco prevention funding, much less than the $20 million suggested by the U.S. Centers for Disease Control and Prevention. Kentucky ranks 37th in the nation in its tobacco prevention spending.

Kentucky collects about $250 million from tobacco taxes and tobacco settlement payments. The $2.7 million is dispersed to state health departments that allocate money toward local community tobacco prevention programs, said Irene Centers, program manager for the state's Tobacco and Prevention and Cessation Program.

In Northern Kentucky, schools offer alternatives to suspension and detention, said Andrea Starr senior health educator with the Northern Kentucky Health Department. One program offers students eight one-hour sessions on tobacco education and an eight-week voluntary cessation program for youths in grades 7-12.

"It's just really teaching healthy lifestyles," said Centers. "There isn't one size fits all, particularly when you're trying to quit smoking. Most people will try to quit at least six to eight times before they actually do."

Reynolds travels the country speaking about smoking prevention. Aside from a media campaign, the best way to engage youth in the dangers of smoking is to give them the responsibility for their own health, he said.

"Condition your kids that they are responsible, program them," he said. "Later when they get a little older, you can say, 'Honey, I'm not worried about you smoking because I know how responsible you are,'" he said.