Advertising and Promotion of Tobacco Encourage Smoking Among Youth: Study

“Though there are qualifications (for example, the bans in Canada and New Zealand are relatively recent and so may not yet have had their full impact), the current evidence available on these four countries indicates a significant effect. In each case the banning of advertising was followed by a fall in smoking on a scale which cannot reasonably be attributed to other factors.”

Based on this evidence, the Food and Drug Administration (FDA) came to the following conclusion in promulgating its rules on tobacco sales and marketing:

“FDA finds that the international experience provides empirical evidence that restrictions on tobacco advertising, when given appropriate scope and when fully implemented, will reduce cigarette and smokeless tobacco use among children and adolescents under the age of 18.”9

These findings from country-level data, described above in Sections III and IV, have been confirmed by studies on the effects of cigarette advertising at a “micro” level — i.e., involving individuals — as described below.

V. Tobacco advertising and promotion have material effects on children and adolescents

A. Tobacco advertising and promotion reach children and adolescents

In considering the effects of tobacco advertising on children and adolescents, the first issue to address is whether advertising and promotion reach children and adolescents. Although the tobacco and advertising industries deny that advertising is targeted to children — denials that are contradicted by internal industry documents that have surfaced in recent years — the key question is whether minors are exposed to advertising. Substantial evidence indicates clearly that they are indeed so exposed.

An example of a study confirming the exposure of children to tobacco advertising was published in the Journal of the American Medical Association (JAMA). Investigators showed that 91% of six-year-old children from five different states correctly matched a picture of “Joe Camel” with a picture of a cigarette, similar to the percentage who recognized the logo of the Disney Channel (a silhouette of Mickey Mouse).10

Confirmatory evidence came from two studies funded by R.J. Reynolds Tobacco Company (RJR). One of these studies found that 72% of six-year-olds and 52% of children aged 3-6 years could identify Joe Camel.11 The other study, conducted for RJR by Roper Starch, surveyed more than 1,000 children aged 10-17. Of these children, 86% recognized Joe Camel, in both aided and unaided recall, 95% of whom knew that he sold cigarettes.12

Further evidence derives from studies measuring children’s recognition of cigarette brands, models, logos, and slogans in cigarette advertisements in which identifying information has been obscured. Another study published in JAMA found that students in grades 9-12 in five different states were much more likely than adults to recognize Joe Camel as a character whom they had seen before, and to identify the products being advertised and the brand name of the product.13 In a study of 11- to 14-year-olds in Australia, Chapman and Fitzgerald found that children who reported smoking in the last four weeks were almost two times more likely to correctly identify the edited advertisements and to complete the slogans than were children who reported not having smoked during that period.14 Similar findings have been reported from Georgia,15 Massachusetts,16 and North Carolina17 (USA); the United Kingdom; 18-20 and Hong Kong.21

Additional evidence that tobacco promotions reach children and adolescents comes from studies showing that many youth obtain and use merchandise from “cigarette continuity programs” (e.g., Camel Cash, Marlboro Miles).22-25 Much of this merchandise bears cigarette brand names, such that children become, in essence, walking billboards by wearing Camel T-shirts, Marlboro caps, and so on. These programs are advertised heavily on billboards, as demonstrated by a photograph I took of a billboard for Marlboro Gear (in front of a Toys “R” Us store and a Chuck E Cheese’s Pizza establishment), which was reproduced with an editorial I wrote on the subject.13c

Exposure of children and adolescents to cigarette advertising and promotion is not surprising given the ubiquity of, and heavy expenditures for, these marketing activities. In recent years, cigarette companies have spent more than $5 billion per year ($160 per second) to advertise and promote cigarettes.27 Children and adolescents are exposed to most of the media used for tobacco advertising (especially billboards — see Section VI below).

The Institute of Medicine, in an expert committee report entitled “Growing Up Tobacco Free,” reviewed the evidence on the extent of tobacco advertising and its effects on youth.28 With respect to youth exposure to tobacco advertising and promotion, it concluded:

“Tobacco advertising is characterized by images and themes that are especially appealing to adolescents, and some are appealing to children. In addition, a large proportion of promotional expenditures associate use of tobacco with activities and products that are attractive to children and youths. The sheer amount of expenditures for advertising and promotion assures that young people will be exposed to these messages on a massive scale. It is clear that society’s efforts to discourage young people from smoking are obstructed — and perhaps fatally undermined — by the industry’s efforts to portray their dangerous products in a positive light.”