Advertising and Promotion of Tobacco Encourage Smoking Among Youth: Study

Pierce et al.40 extended these findings in a longitudinal study design. A total of 1,752 of the adolescents who were not susceptible to smoking when first interviewed in 1993 were re-interviewed in 1996. In a measure of receptivity to tobacco marketing similar to that used by Evans et al,34 Pierce et al. defined receptivity as minimal if the respondent did not name a brand when asked to identify the brand advertised the most on billboards or in magazines recently seen. If respondents also had a favorite advertisement, they would be considered to have moderate receptivity. Respondents who said that they had bought or received a promotional item from a tobacco company, or that they would ever use a promotional item, were classified as highly receptive to advertising. Pierce and colleagues then investigated the progression toward smoking of the non-susceptible never-smokers.

In a logistic regression analysis of predictors of which adolescents progressed toward smoking, Pierce et al. found that

“The baseline receptivity (in 1993) to tobacco industry promotional activities was strongly related to which adolescents progressed toward smoking. Among those who were assessed as having a minimal level of receptivity, 37.7% progressed toward smoking. Compared with this group, those who had a favorite advertisement but who were not willing to use a promotional item (the moderate level) were 82% more likely to progress toward smoking, which is a statistically significant increase compared with those at the minimal level. Those with a high level of receptivity (at least willing to use a promotional item) were almost 3 times more likely to progress toward smoking, which was highly statistically significant.”40

The authors estimated that 34% of all smoking experimentation in California between 1993 and 1996 can be attributed to tobacco promotional activities, translating to experimentation by 700,000 adolescents nationally.40

In summary, the evidence from these two longitudinal studies39, 40 extends the findings from many cross-sectional studies, and confirms that awareness and approval of tobacco advertising and promotion, and “receptivity” to tobacco marketing, are causal factors in smoking initiation among youth.

3. Relationship between cigarette advertising and brand preference among youth

Another line of evidence indicating the effect of tobacco advertising and promotion on youth is the relationship between cigarette advertising and brand preference among youth. In a study of students in two junior high schools in the Chicago area, seventh- and eighth-grade children who smoked were asked to view a series of cigarette advertisements and to rate how much they “liked” each ad. The investigators found that the students’ cigarette buying preferences closely paralleled the perceived appeal of the cigarette advertisements.41

Particularly compelling evidence is the huge increase in teenage use of Camel cigarettes coinciding with R.J. Reynolds’ youth-oriented “Joe Camel” advertising campaign.13, 42 - 44 Furthermore, studies have shown that youth find Joe Camel to be appealing.13, 41 Similarly, tobacco advertising campaigns targeting women beginning in the late 1960s (i.e., Virginia Slims) were associated with a major increase in smoking initiation among adolescent girls.45 In general, the brand choices of adolescent smokers reflect the brands with the largest advertising budgets.43, 44 Especially noteworthy is the finding by Pollay and colleagues that the relationship between brand choices and brand advertising is about three times stronger among teenagers than among adults.46 Based on this area of research, the FDA came to the following conclusion:

“… these studies are evidence that, when considered together, form a coherent pattern that establishes the role that advertising plays in young people’s smoking behavior.”47

4. Other evidence

King et al. showed that cigarette brands popular among adolescent smokers are more likely than “adult brands” to be advertised in magazines with high youth readerships.48 This suggests that exposure to advertising affects smoking behavior and cigarette brand preference among youth.

The evidence summarized in this section (V. B), taken as a whole, makes a persuasive case that tobacco advertising and promotion increase tobacco use among children and adolescents.

VI. Billboards represent a particularly effective and intrusive medium for advertising in general, and for promotion of cigarettes in particular (especially to children)

There are a number of reasons why tobacco billboards warrant special concern with respect to their impact on youth:

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; and
4. billboards in urban, inner-city environments are more likely to carry tobacco and alcohol advertisements, often targeted to racial and ethnic minorities.

A. Billboards are a favorite medium for tobacco advertising.

There are two ways in which we can look at expenditures for tobacco advertising on billboards. The first is the proportion of total tobacco marketing expenditures devoted to billboards. This gives us a measure of how important billboards are in tobacco company marketing efforts. The second is the proportion of total advertising in various media devoted to tobacco. This gives us a measure of the extent to which tobacco advertising dominates those media.