11.1 The merits of banning tobacco advertising

Tobacco companies have always defended their promotions by claiming that advertising serves only to encourage adult smokers to switch or try new brands.1

'Our business is not about persuading people to smoke; it is about offering quality brands to adults who have already taken the decision to smoke.' British American Tobacco Australia website 20112

Encouraging use of particular brands among existing users is certainly one important function of tobacco advertising. However, published research shows that tobacco advertising is also associated with an increase in overall tobacco consumption.3 Smokers can be prompted to smoke more frequently and those who are in the process of quitting can be lured back to the product through the promotion of familiar and reassuring brands. New smokers, primarily adolescents, enter the cigarette market every day. About 16 500 teenagers under the age of 18 make the transition from experimental to established patterns of smoking each year in Australia—refer Chapter 1, Section 1.6.

Restriction of the advertising of tobacco products is an important focus for comprehensive tobacco control.

The 2008 National Cancer Institute's Monograph 19, The Role of the Media in Promoting and Reducing Tobacco Use, summarises the primary arguments in support of implementing comprehensive bans on tobacco advertising3.4:

  • the devastating health consequences of tobacco use
  • the deceptive and misleading nature of tobacco marketing campaigns
  • the unavoidable exposure of youth to these campaigns
  • the failure of the tobacco industry to effectively self-regulate
  • the ineffectiveness of implementing only partial advertising bans.

An earlier report by the US Surgeon General in 2000 similarly highlighted the influential nature of industry advertising and promotion3:

  • Despite the overwhelming evidence of the adverse health effects from tobacco use, efforts to prevent the onset or continuance of tobacco use face the pervasive challenge of promotional activity by the tobacco industry.
  • The tobacco industry uses a variety of marketing tools and strategies to influence consumer preference, thereby increasing market share and attracting new consumers.
  • Advertising increases consumption of tobacco products by encouraging children or young adults to experiment with tobacco products and initiate regular use, reducing current smokers' motivation to quit and cuing former smokers to resume smoking.
  • Among all US manufacturers, the tobacco industry is one of the most intense in marketing its products. Only the automobile industry markets its products more heavily.

11.1.1 Tobacco advertising increases youth smoking

The industry commonly claims that its promotional activities are not intended to influence and have no impact on children. In contrast, numerous academic reviews have identified tobacco advertising as a key influence on youth to initiate smoking.5–9 Youth exposed to tobacco advertising hold positive attitudes towards tobacco use.8 The industry argues that in the absence of causal proof (that advertising directly induces children to smoke) there is insufficient evidence to justify banning tobacco advertising. However, research examining the impact of the UK's Tobacco Advertising and Promotion Act on youth smoking found that the advertising ban reduced adolescents' smoking intentions by signifying smoking to be less normative and socially unacceptable.10,11

By evaluating the available literature on tobacco promotion against the Bradford Hill criteria, originally developed to explain disease causality, DiFranza and colleagues demonstrated that exposure to tobacco advertising directly causes youth to take up smoking.12 Epidemiologists use these stringent criteria to determine whether a causal link (rather than a statistical association) exists between exposure to a risk factor and development of a disease. The researchers found that the body of published evidence supports the criteria for causality: 'First, children are exposed to tobacco promotion before the initiation of tobacco use. Second, exposure increases the risk for initiation. Third, there is a dose–response relationship, with greater exposure resulting in higher risk. Fourth, the association between exposure and increased risk is robust; it is observed with various study methods, in multiple populations, and with various forms of promotion and persists after controlling for other factors. Fifth, scientifically plausible and theoretically based mechanisms whereby promotion could influence initiation exist. Finally, no explanation other than causality can account for the evidence' (p1245).11

In 1984, Philip Morris lamented how best to address the decreasing sales of its flagship brand, Marlboro, in Australia: 'The key problem seems to be its lack of appeal to younger smokers and this is the area which needs to be addressed. One possibility might be to concentrate on sampling and promotion as many young smokers have never had any first-hand experience with the product' (p1).12 Again, in 1990, Philip Morris recognised the potential for increased sales among Australia's large youth population, 'given predisposition to try/adopt new brands, this segment represents significant market opportunity' (p16).13

Australian experimental research with young smokers and non-smokers showed that incidental positive smoking imagery in magazines (this included photographs of popular musicians, actors and models smoking cigarettes) could also generate the same sorts of consumer effects attributed to tobacco advertising, including intention to smoke.14 Adolescent smokers were particularly attuned to smoking imagery and reported that such imagery increased their urge to smoke and reduced their desire to quit. The authors call for increased monitoring of incidental smoking imagery portrayals in all popular entertainment media to ascertain whether greater regulation is warranted.

11.1.2 Marketing to 'over 18s'

When analysing marketing strategies and effects, it is important to avoid arbitrarily drawing the transition of youth to adulthood as a single event that happens on one's 18th birthday. Decisions made by those turning 18 are plainly affected by influences to which they are exposed before turning 18, including advertising. In internal documents the industry acknowledges the importance of capturing the youth market. The tobacco industry actually uses the term 'young adult' to describe the youth market: 'From time to time when describing market categories and target audiences we use references such as young smokers, young market, youth market etc. These terms do not accurately describe what we are talking about. When describing the low-age end of the cigarette business, the term 'young adult smoker' or 'young adult smoking market' should be used. Please advise all members of your department that these terms should be used in all written materials in the future' (p1).11

Along with their parent companies abroad, Australian tobacco companies developed a 'youth strategy' that has evolved from unabashed marketing to children in the 1950s15 to denial of this practice from the late 1960s, and eventually to the present-day position of concern to show themselves as a socially responsible industry actively campaigning against teenage smoking.16 A core part of this social responsibility is the claim to only market tobacco products to adults aged 18 and over, and to support certain youth tobacco prevention programs. However, as Carter notes: 'It is commonly observed that teens tend to mimic those just older than themselves and strive to establish themselves as independent, and that the industry's youth smoking programs play to those characteristics by emphasising the ''forbidden fruit'' aspects of smoking. As years of dedicated research, media circulation demographics, and even common sense dictates, it is impossible to quarantine those under 18 years of age from aspiring to, or participating in, activities designed for those over 18' (piii75).16

The marketing methods employed by the tobacco industry are often conspicuously connected to youthful interests and activities. Sales tents at music festivals,17 development and distribution of lifestyle magazines,18 concert sponsorship19 and partnerships with fashion outlets and events20 are just a few examples of how the industry strategically targets the young adult audience.

An RJ Reynolds report explains the vital importance of young smokers: 'Younger adult smokers have been the critical factor in the growth and decline of every major brand and company over the last 50 years. They will continue to be just as important to brands/ companies in the future for two simple reasons: The renewal of the market stems almost entirely from 18-year-old smokers. No more than 5% of smokers start after age 24. (And) the brand loyalty of 18-year-old smokers far outweighs any tendency to switch with age' (p1).21

11.1.3 Awareness of tobacco marketing

As part of a four-country study on tobacco control in 2006, 1767 Australian adult smokers were surveyed about their awareness of tobacco industry advertising.22 The research findings are detailed in Table 11.1.1. Generally, respondents reported low awareness of most types of advertising, reflecting the fact that tobacco advertising has become increasingly restricted in all states and territories since the 1990s. There were relatively high levels of awareness of advertising in stores (33%), of special price offers for cigarettes (23%) and of sports sponsorship (21.6%). This is consistent with the 2003 findings of Harris and colleagues23 using the same survey tool, and reflects gaps in tobacco advertising legislation. At the time of the 2006 survey, no state or territory had yet banned the retail display of tobacco products, and sponsorship of the high-profile Formula 1 Australian Grand Prix ended only months before the survey.

Table 11.1.1
Awareness of tobacco marketing among Australian smokers in the previous six months, 2006 (n=1767)

 

% of respondents aware

Salience: noticed things that encourage smoking in the last 6 months

18.9

Type of marketing

 

Noticed tobacco advertisements in any of the five media (television, radio, posters/billboards, newspaper/magazines and stores)

40.2

 

Noticed tobacco advertisement in stores

33.0

Sponsorship

 

Noticed sports sponsorship

21.6

 

Noticed arts sponsorship

1.9

 

Noticed any type of sponsorship

22.1

Promotions

 

Noticed special price offers for cigarettes

23.0

 

Noticed any form of promotion (excluding special price offers, and including free samples of cigarettes, gifts/discounts on other products, clothing with cigarettes brand name and competitions linked to cigarettes)

31.0

Total noticing tobacco marketing in any channel

60.3

Source: Yong HH, Borland R, Hammond D, Sirirassamee B, Ritthiphakdee B, Awang R, et al. Levels and correlates of awareness of tobacco promotional activities among adult smokers in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia (IT C-SEA) Survey. Tobacco Control. 2008;17(1):4652.

11.1.4 Industry arguments to retain tobacco advertising

In addition to its claims that advertising does not influence the uptake of smoking by young people, and that advertising bans would not be at all effective in reducing smoking, the tobacco industry uses other 'key messages' when lobbying against advertising bans.

11.1.4.1 Freedom of speech

Companies often cite 'freedom of speech' protection, arguing that they have a right to inform consumers about their products. This erroneously implies that cigarette advertisements contain important consumer information and that smokers base their decision to smoke by weighing up such information and making an educated choice. Most cigarette advertising has little to no 'information' other than the brand name. This argument also ignores the fact that most smokers commence before they are consenting adults—refer Chapter 1, Section 1.6 and Chapter 5. Most smokers are also inadequately informed about the harms of smoking, in part due to historic tobacco industry efforts to discredit health information.23 Tobacco companies have only in relatively recent times publicly acknowledged that smoking causes disease, having 'maintained the stance that smoking had not been proven to be injurious to health through 1999' (pi110).24

11.1.4.2 Legal product

A common industry argument is that tobacco is a legal product and therefore should be legal to advertise. Manufacturers of other legal products, however, are also subject to a range of advertising restrictions and conditions, including for public health reasons.25 Internationally, governments have banned or restricted advertising for other legal products, such as prescription-only pharmaceuticals, guns, explosives and some industrial chemicals.26 Further, tobacco is not freely sold in Australia; it is illegal to sell cigarettes to children (under age 18) and most states and territories require retailers to obtain a tobacco sales licence. In that context, advertising restrictions cannot be described as inconsistent.

11.1.4.3 Brand switching

As previously described, the industry publicly states that advertising and promotion only serve to encourage brand switching among adult smokers. Clive Turner, when with the UK-based Tobacco Advisory Council, encapsulated the industry position: 'Certainly no tobacco advertising is concerned with encouraging non-smokers to start or existing smokers to smoke more and it seems blindingly obvious that, unless you are a smoker, tobacco advertising or sponsorship has absolutely no influence whatsoever in persuading or motivating a purchase' (p8).1 But according to advertising executive Emerson Foote, former CEO of the international advertising group McCann-Erickson, which has handled millions of dollars in tobacco industry accounts: 'The cigarette industry has been artfully maintaining that cigarette advertising has nothing to do with total sales. This is complete and utter nonsense. The industry knows it is nonsense. I am always amused by the suggestion that advertising, a function that has been shown to increase consumption of virtually every other product, somehow miraculously fails to work for tobacco products' (p8).1

While brand switching does occur, it is not common among smokers. As part of a retail intercept survey with smokers who had made a tobacco purchase immediately beforehand, only 5% (11 of 206 participants) responded that they had not bought their usual brand.27 When asked 'What prompted you to try this brand?' five said they were trying a different brand on the recommendation of another person, and only six said they wanted to 'try something different' or 'felt like a change'.

11.1.5 The effects of advertising bans

The effectiveness of advertising bans in reducing tobacco use and 'denormalising' tobacco products are much more plausible reasons for tobacco industry opposition. Advertising bans lead to dramatic declines in the awareness of tobacco industry promotional activities.22 More importantly, regulating advertising and promotion can reduce both the prevalence and initiation of smoking. Based on an analysis of tobacco use before and after the introduction of advertising bans in numerous countries, it is estimated that comprehensive advertising bans reduce smoking initiation by an average of 6% and smoking prevalence by an average of 4%. A partial ban is likely to only reduce prevalence and initiation by 2%.6

Empirical evidence also shows that comprehensive advertising bans reduce tobacco consumption, but that incomplete bans have little or no effect because companies transfer expenditure to media in which advertising is still allowed.28, 29 A review of the effects of tobacco adverting ban laws in 30 developing countries showed that comprehensive bans resulted in a 23.5% reduction in per capita consumption of tobacco.30 Comprehensive advertising bans are essential to reducing the health burden of tobacco use.

Recent news and research

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