Advertising and Promotion of Tobacco Encourage Smoking Among Youth: Study

(The report below is from The International Tobacco-Control Network and was prepared by Ronald M. Davis, M.D. in 1998. Dr. David was the director of the Center for Health Promotion and Disease Prevention of the Henry Ford Health System in the United States.)

CONTENTS

1. Background and author’s qualifications
2. How tobacco advertising and promotion affect tobacco consumption
3. Evidence that advertising and promotion affect overall tobacco consumption
4. Countries with tobacco advertising bans have lower consumption (or slower increases in consumption) than those without bans
5. Tobacco advertising and promotion have material effects on children and adolescents
A. Tobacco advertising and promotion reach children and adolescents
B. Tobacco advertising and promotion increase tobacco use by children and adolescents

# Cross-sectional studies
# Longitudinal studies
# Relationship between cigarette advertising and brand preference among youth
# Other evidence
# Billboards represent a particularly effective and intrusive medium for advertising in general, and for promotion of cigarettes in particular (especially to children)

1. Billboards are a favorite medium for tobacco advertising
2. Billboards are intrusive and cannot be avoided
3. Billboards are in people’s neighborhoods and are constantly exposing youth and adults to unsolicited messages
4. Billboards in urban, inner-city environments are more likely to carry tobacco and alcohol advertisements, often targeted to racial and ethnic minorities

# Conclusions

1. Conclusions of the 1994 Surgeon General’s report
2. Conclusions of the Food and Drug Administration
3. My own conclusions

# References
# Appendix. Author’s biographical sketch

I. Background and author’s qualifications

I have been asked by the City of Chicago Law Department to provide an expert opinion on issues related to the effects of tobacco advertising and promotion on youth, and the importance of legislation that would restrict the placement of tobacco billboards within the city. I have also been asked to describe my qualifications to render these opinions, and my involvement as an expert witness in other tobacco-related litigation.

A biographical sketch is attached as an Appendix to this report. It summarizes my professional career. A longer and more detailed curriculum vitae has also been made available. In brief, I am a physician with board certification in preventive medicine, and an epidemiologist trained at the U.S. Centers for Disease Control and Prevention (CDC). My current position is Director of the Center for Health Promotion and Disease Prevention at the Henry Ford Health System, a large managed care organization in Southeast Michigan serving approximately 850,000 residents of the state. I was Chief Medical Officer for the Michigan Department of Public Health from 1991 to 1995, and Director of the CDC’s Office on Smoking and Health from 1987 to 1991. I currently serve as chair of the American Medical Association’s Council on Scientific Affairs, and I am editor of Tobacco Control, an international journal published quarterly by the British Medical Association.

In this report, per the request from the City of Chicago Law Department, I will focus primarily on the epidemiologic evidence related to the effects of tobacco advertising and promotion on youth. I will not review in any detail the evidence on the psychosocial effects of advertising and promotion (e.g., how the imagery and messages in tobacco advertising appeal to the developmental needs of youth). Nor will I review the many industry documents that have come to light in recent months and years that bear upon this issue.

I will base my opinions on my background as a physician, as an epidemiologist, as one who has conducted substantial research on tobacco advertising and promotion for at least a dozen years, and as one who has worked extensively in the field of tobacco and health during the past two decades. The research I have performed is documented in the journal articles I have published, which are listed in my curriculum vitae.

Two roles in particular have put me in a position where I have been exposed to a breadth of information on this subject. One of these was my tenure as director of the CDC’s Office on Smoking and Health, which is the lead federal office relating to tobacco and health. The Office produces the annual Surgeon General’s reports on smoking and health, which use a rigorous peer-review process in summarizing the scientific literature in the field, and maintains the world’s largest bibliographic database containing technical material on the subject.

The other important role is my service, since 1992, as editor of Tobacco Control, which is the only journal in the world devoted to this subject. Serving as editor has ensured my awareness of the pertinent research being conducted in the field.

I have served as an expert witness in several other tobacco-related lawsuits, including the State Attorney General lawsuits filed in Mississippi, Texas, and Washington State, and the Broin and Engle class actions filed in Florida.