5.15 Tobacco advertising and promotion targeted at young people

Major scientific reviews have concluded that tobacco advertising and promotion have directly influenced the uptake of smoking by young people.^1-5 The 2012 US Surgeon General’s report concluded that “The evidence is sufficient to conclude that there is a causal relationship between advertising and promotional efforts of the tobacco companies and the initiation and progression of tobacco use among young people”p.6.¹ In another major review drawing on research published between 1966 and 2005, researchers concluded that the evidence satisfies all six standard statistical criteriaⁱ for determining that exposure to tobacco advertising causes the uptake of smoking in children.⁶ They explained these criteria as:

• temporality—children are exposed to tobacco promotion prior to taking up smoking
• exposure—being exposed to advertising increases the risk of smoking over the non-exposed
• dose–response—the more exposed the population to advertising, the greater the likelihood of taking up smoking
• robust and consistent findings—observed across a large number of studies and populations, and controlled for confounding factors
• causality is theoretically and scientifically plausible
• no explanation other than causality fits the factual evidence.

Banning or restricting tobacco advertising and marketing has been shown to reduce smoking among young people. Research from the UK, for example, examined adolescent smoking intentions and tobacco marketing before and after the implementation of restrictions on advertising through the UK’s Tobacco Advertising and Promotion Act between 2003 and 2005.⁷ The Act included advertising bans on billboards, cinemas and in print media, prohibition of domestic tobacco sponsorship, direct mail and on-pack promotions, and restricted point-of-sale advertising. The authors concluded that restrictions on tobacco advertising can significantly reduce adolescents’ smoking intentions by signifying smoking to be less normative and to be socially unacceptable.⁷ A 2025 systematic review and meta-analysis of studies across countries found that bans on tobacco advertising, promotion and sponsorship were associated with a 37% reduced risk of smoking initiation and a 20% lower odds of current smoking.⁸

Most forms of tobacco advertising and promotion in Australia have been incrementally banned since 1973 by federal and state legislation (see Chapter 11). However, tobacco manufacturers have often adapted to restrictions by increasing activity in those areas where promotion was still allowed to occur, for example during the early 2000s at retail outlets, through events promotions, and via targeted products and packaging (see Section 5.13 and InDepth 11A). More recently, the tobacco industry has turned to the rapidly evolving digital media environment, including social media. This transnational and ubiquitous platform has enabled the tobacco industry to exploit and develop new forms of promotion targeted at young people globally.^9-12

While the tobacco industry has been claiming it wants to end cigarette sales and that it is shifting towards alternative nicotine products, companies continue to launch global advertising campaigns aimed at recruiting young people to smoke combustible cigarettes. In 2026 Philip Morris International’s (PMI) “I AM Marlboro” global campaign included billboards, TV ads, online content, as well as point of sale (POS) displays and competitions to win campaign-branded merchandise through buying cigarettes.¹³ PMI has filed or owns campaign-related trademarks in about 20 countries internationally, including the Philippines, Indonesia, Morocco, Bangladesh and Germany. Tobacco advocates and researchers have condemned the ‘I AM Marlboro’ campaign, saying it directly targets a young, rather than adult, audience, by appealing to young people’s search for identity, belonging, self-expression and lifestyle and then tying that to smoking Marlboro cigarettes. Young people may be vulnerable to this type of marketing, as they are still in a process of identity formation.¹³

5.15.1 Point-of-sale displays

See Section 11.9 for a comprehensive account of retail promotion at point-of-sale, and Section 11.9.3.2 specifically for evidence on the effects of retail advertising and display on uptake. For an account of the legislation banning the display of tobacco products at point- of- sale in Australian states and territories during the 2000s—see Section 11.4.

5.15.2 Event marketing

In Australia⁹ and overseas,^14,15 the tobacco industry has targeted young adults by sponsoring a range of events such as fashion shows, dance parties and music events, often staged in bars and nightclubs.

Past research has identified several ways in which event marketing has been strategically important to the tobacco industry:⁹

• such events promote brand loyalty
• they may tip the balance between experimentation and regular use/addition
• they provide a positive social context in which smoking can occur, serving to reinforce smoking as well as encourage uptake
• co-sponsorship of events by other brands oriented toward young people (such as sports drinks) normalises smoking behaviour
• they actively encourage participants (by offering incentives) to spread the word about the events and bring along more people, thereby extending the industry’s reach.

Philip Morris Australia promoted its brand Alpine through young designer fashion shows and dance parties between 2000 and 2002; these events were themed in Alpine colours and included roving cigarette sellers dressed in the Alpine brand colours.⁹ Other events have featured accessories bearing brand logos, new packaging and ‘special edition’ product configurations, free drinks and discounts on cigarettes. The events have encouraged participants to sign on to an email database, providing the organisers with client contact details and profiles as well as facilitating publicity about future events.⁹

Prior to the introduction of the internet and social media, event marketing was confined by the limits of geography and guest lists. The rise of social media and the use of influencers with immense online followings has enormously and instantaneously expanded event marketings reach transnationally. See Section 11.11.1.2 for information on the promotion of smoking at events using social media influencers.

5.15.3 Online digital media

As mentioned above, the global and largely underregulated nature of the Internet provides vast opportunities for the promotion and sale of tobacco. Young people in particular are at high risk of exposure due to the substantial amount of time they spend online.¹⁶ Online content can be created and uploaded in one country and then viewed and shared in another. Cross-border digital media consumption provides a myriad of ways through which the tobacco industry can circumvent TAPS bans.¹²

A 2016 Australian study found that past-month exposure to internet-based tobacco advertising and branding among young people increased over the years of the survey (advertising: 21% in 2010 to 29% in 2013; branding: 20% in 2010 to 26% in 2013). The participants who were younger, female, from lower socioeconomic status, and never-smokers were more likely to report exposure. Facebook was the most commonly cited platform for encountering tobacco branding in 2013 (22% of all branding). Compared with young people interviewed in 2013, participants in 2010 were significantly less likely to report exposure to tobacco branding on social media. Among never-smokers aged 12-17 years, exposure to online advertising and branding or branding alone were significant predictors of smoking susceptibility.¹⁷

A US study of national trends of adolescent exposure to tobacco advertisements from 2012–2020 found that combustible cigarette marketing remained high across all years, while an increase in trends for cigarette advertising exposure was observed from 2017 to 2020, after an initial drop in 2015. The upwards trend was driven by retail store-based (which remained high and stable) and internet-based exposure (other exposure sites included newspapers and magazines, and TV, movies and streaming services).¹⁸ This confirms other researchers’ hypothesis that studies reporting declines¹⁹ in pro-tobacco messaging exposures reflect the fact that tobacco companies have pivoted to advertising through online media, over traditional forms.²⁰

Research shows a substantial proportion of adolescents in countries that have banned tobacco advertising are still exposed to advertisements for tobacco products online.¹⁶ A 2023 study¹⁶ examining the prevalence of adolescent exposure to online tobacco advertisements and promotions found that many adolescents, regardless of whether they had smoked before or not, reported having seen tobacco advertisements online and promotions that make tobacco use look fun or cool. Prevalence of adolescent exposure to online advertisements for tobacco products ranged from 18.2%-34.3%. Exposure to tobacco advertising online were prevalent even in countries with the highest WHO FCTC level of advertising bans.¹⁶

Research has shown that a substantial number of young people engage with at least one form of online tobacco-promotion. Such engagement may represent an important risk factor for tobacco use among young people, with higher levels of online engagement found to be associated with greater susceptibility to tobacco use among never-tobacco users and ever having tried tobacco.²¹ Online pro-smoking media and advertising has been found to increase smoking susceptibility and initiation among young people.²² In a 2023 study, reporting seeing tobacco advertising online that looked fun or cool was positively associated with the prevalence of past-month smoking among adolescents.¹⁶

5.15.3.1 Social media

Since conventional media was deemed off-limits to tobacco companies, social media platforms such as Tik Tok, Instagram, Snapchat, Facebook, YouTube, and X (formally known as Twitter), have become an enticing form of relativity underregulated new media teeming with a global audience of young people. Social media blurs the line between entertainment and advertising for users, and offers to those wishing to use it for advertising advanced features that allow for precision targeting of consumer markets.²³ Pro-tobacco content most prevalent on social media includes promotion, product features, user experience, and lifestyle.²⁴ Direct, paid tobacco advertisements on online social media are the easiest form of online TAPS to recognise, monitor and enforce. However, it can be difficult to distinguish between paid tobacco promotion and tobacco content that has no commercial connection.¹² Moreover, paid tobacco advertising through social media influencers is not consistently disclosed nor easy to recognise. A 2024 study found that 61% of young people within the study who had used social media in the past month had encountered tobacco-related content.²⁵ Tobacco related content on social media is most commonly portrayed in a positive light, with one study finding 60% of tobacco-related content on social media portrayed positively, and 10% neutrally.²⁶

Research focusing on social media depictions of tobacco and young people has found an associated impact on tobacco uptake, use, susceptibility, as well as attitudes, risk perceptions and perceived peer smoking norms. Social media exposure to tobacco promotions can generate favourable attitudes towards tobacco. A 2014 US study found that among young people who had never used tobacco, exposure to tobacco promotions on Facebook was associated with: a higher likelihood of thinking that people who smoked looked cool and had more friends, a willingness to smoke if a friend offered, and being less likely to believe that tobacco products and second-hand smoke were dangerous.²⁷ Among never tobacco users, 14-15 year olds were more likely to have some pro-tobacco attitudes.²⁷

Both exposure to and interactions with social media tobacco content have a significant impact on the patterns of tobacco use by adolescents.¹² Heavy social media use, and especially following tobacco brands, may increase the likelihood of teens starting smoking.²⁸ A 2022 meta-analysis of studies of adolescents, young adults and adults, found that exposure to tobacco content on social media was associated with increased likelihood of lifetime tobacco use, current tobacco use (past 30 days), and susceptibility to use tobacco among never smokers.²⁹ Other research also suggests that young people who regularly see tobacco-related posts from influencers and celebrities are more likely to become curious about or intend to use tobacco products.²⁵ As well as associations with intentions to smoke, a 2016 research study²² in the US found both expressing and/or receiving pro-smoking messages through online social media had significant associations with smoking attitudes among young university students. Students who expressed and/or received pro-smoking messages on social media tended to perceive their peers as doing the same, regardless of whether they were. Consequently, the increased perceived peer expression led to greater perceived peer smoking norms, resulting in more favourable smoking attitudes as well as higher smoking intentions.²² Other research has also highlighted the potential negative impact of positive tobacco content on social media on attitudes, behaviours and risk perceptions relating to tobacco use, particularly among adolescents and young adults who are the primary users of social media.²⁶ A 2023 systematic review and meta-analysis³⁰ on the association between exposure to e-cigarette and tobacco-related content and behaviours and attitudes of young people found an association between exposure to and engagement with tobacco products on social media and use or pro-use attitudes among young people.³⁰

For a comprehensive summary of online social media influencers promotion tobacco use see Section 11.11.1 Social media. And for information of the regulation of online tobacco promotion see Section 11.11.3 Regulation of online tobacco promotions.

5.15.4 Anti-smoking advertising by the tobacco industry

Smoking prevention activities for young people have been adopted by the tobacco industry internationally, in response to criticism that the industry has actively encouraged young people to smoke. In many countries these activities have taken the form of anti-smoking advertising, placed mainly on television and in magazines.

There is strong evidence that these advertisements merely served to promote a positive corporate image without reducing intentions to smoke.^31,32 Analysis of transcripts from US tobacco litigation cases between 1992 and 2002 revealed that while the industry invested heavily in financing anti-tobacco advertising and other programs, there has only been very limited evaluation of program effectiveness; the focus has tended to be on aspects such as program reach and uptake rather than on any demonstrable effects on smoking among young people.³³ In fact, industry anti-tobacco advertising may have fostered a more positive attitude towards the tobacco companies among young people,^34,35 and may have influenced teenagers to take up smoking.³³ There is also evidence that smoking prevention initiatives for young people have been used to bolster the defence strategies of the tobacco industry in the face of increasing tobacco litigation in the US.³³ Industry anti-tobacco advertising campaigns are discussed in greater detail in Chapter 10, Section 10.13.3.

See Chapter 11, Section 11.11.4 for information on internet promotion through corporate social responsibility.

i These criteria are also applied to disease causality. See Chapter 3, Section 3.0, Box 3.0.1 for a further discussion of defining causality and the criteria used to infer the likelihood of causality.

Test your knowledge

References

1. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012. Available from: https://www.ncbi.nlm.nih.gov/books/NBK99237/pdf/Bookshelf_NBK99237.pdf.

2. S Department of Health and Human Services. Reducing tobacco use: a report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000. Available from: https://pubmed.ncbi.nlm.nih.gov/11190114/.

3. Lovato C, Linn G, Stead L, and Best A. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours (review). Cochrane Database of Systematic Reviews, 2003; 4:CD003439. Available from: https://pubmed.ncbi.nlm.nih.gov/14583977/

4. Turner L, Mermelstein R, and Flay B. Individual and contextual influences on adolescent smoking. Annals of the New York Academy of Sciences, 2004; 1021:175–97. Available from: https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1196/annals.1308.023

5. Wakefield M, Flay B, Nichter M, and Giovino G. Role of the media in influencing trajectories of youth smoking. Addiction, 2003; 98 Suppl 1(suppl.1):79-103. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12752363

6. DiFranza JR, Wellman RJ, Sargent JD, Weitzman M, Hipple BJ, et al. Tobacco promotion and the initiation of tobacco use: assessing the evidence for causality. Pediatrics, 2006; 117(6):e1237-48. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16740823

7. Brown A and Moodie C. The influence of tobacco marketing on adolescent smoking intentions via normative beliefs. Health Education Research, 2009; 24(4):721-33. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19286895

8. Saad C, Cheng BH, Takamizawa R, Thakur A, Lee CW, et al. Effectiveness of tobacco advertising, promotion and sponsorship bans on smoking prevalence, initiation and cessation: a systematic review and meta-analysis. Tobacco Control, 2025. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39805696

9. Harper T and Martin J. Under the radar - how the tobacco industry targets youth in Australia. Drug and Alcohol Review, 2002; 21:387–92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12537709

10. Ribisl K. The potential of the internet as a medium to encourage and discourage youth tobacco use Tobacco Control, 2003; 12(suppl.1):i48-59. Available from: http://tobaccocontrol.bmj.com/cgi/reprint/12/suppl_1/i48

11. Freeman B and Chapman S. Is "YouTube" telling or selling you something? Tobacco content on the YouTube video-sharing website. Tobacco Control, 2007; 16(3):207-10. Available from: https://tobaccocontrol.bmj.com/content/tobaccocontrol/16/3/207.full.pdf

12. WHO study group on tobacco product regulation. Report on the scientific basis of tobacco product regulation: ninth report of a WHO study group. Geneva: World Health Organization, 2023. Available from: https://iris.who.int/bitstream/handle/10665/372463/9789240079410-eng.pdf.

13. Lay K. Marlboro maker accused of ‘exploiting’ young people with new global ad campaign. The Guardian, 2026. Available from: https://www.theguardian.com/society/2026/may/15/marlboro-maker-philip-morris-international-young-people-new-global-advertising-campaign#img-1

14. Katz SK and Lavack AM. Tobacco related bar promotions: insights from tobacco industry documents. Tobacco Control, 2002; 11 Suppl 1(suppl.1):I92-101. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11893819

15. Sepe E, Ling PM, and Glantz SA. Smooth moves: bar and nightclub tobacco promotions that target young adults. American Journal of Public Health, 2002; 92(3):414-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11867322

16. Leung J, Lim C, McClure-Thomas C, Foo S, Sebayang S, et al. Adolescent Exposure to Online Advertisements and Promotions for Tobacco Products on the Internet-A Cross-Sectional Analysis of the Global Youth Tobacco Surveys. Journal of Adolescent Health, 2023. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37737754

17. Dunlop S, Freeman B, and Perez D. Exposure to Internet-Based Tobacco Advertising and Branding: Results From Population Surveys of Australian Youth 2010-2013. Journal of Medical Internet Research, 2016; 18(6):e104. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27338761

18. Li X, Kaiser N, Borodovsky JT, Riordan R, Kasson E, et al. National Trends of Adolescent Exposure to Tobacco Advertisements: 2012-2020. Pediatrics, 2021; 148(6). Available from: https://www.ncbi.nlm.nih.gov/pubmed/34851424

19. Ma C, Yang H, Sun J, Zhao M, Magnussen CG, et al. Proportions of and trends in exposure to pro-tobacco and anti-tobacco advertisements among young adolescents aged 12-16 years in 142 countries and territories, 1999-2018: an analysis of repeated cross-sectional surveys. Lancet Glob Health, 2023; 11(4):e586-e96. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36925178

20. Keller-Hamilton B and Ferketich AK. Importance of online exposures to pro-tobacco messaging. Lancet Glob Health, 2023; 11(4):e491-e2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36925163

21. Soneji S, Pierce JP, Choi K, Portnoy DB, Margolis KA, et al. Engagement With Online Tobacco Marketing and Associations With Tobacco Product Use Among U.S. Youth. Journal of Adolescent Health, 2017; 61(1):61-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28363720

22. Yoo W, Yang J, and Cho E. How social media influence college students' smoking attitudes and intentions. Computers in Human Behavior, 2016; 64:173-82. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27956757

23. Vassallo A, Jones A, and Freeman B. Social media: frenemy of public health? Public Health Nutrition, 2022; 25(1):61-4. Available from: https://www.cambridge.org/core/product/58342A367E201A3542744DDA5F3BD910

24. Donaldson SI, Dormanesh A, Majmundar A, Pérez C, Lopez H, et al. Examining the Peer-Reviewed Literature on Tobacco-Related Social Media Data: Scoping Review. Nicotine and Tobacco Research, 2024; 26(4):413-20. Available from: https://doi.org/10.1093/ntr/ntad186

25. Lim CCW, Sun T, Hall W, Gartner C, and Connor JP. Swipe to Inhale: Tobacco-Related Content on Social Media and Susceptibility to Tobacco Use. American Journal of Preventive Medicine, 2024. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39254617

26. Rutherford BN, Lim CCW, Johnson B, Cheng B, Chung J, et al. #TurntTrending: a systematic review of substance use portrayals on social media platforms. Addiction, 2023; 118(2):206-17.

27. Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Grucza RA, and Bierut LJ. The hazards of new media: youth’s exposure to tobacco ads/promotions. Nicotine Tob Res 2014; 16:437–44. Available from: https://academic.oup.com/ntr/article/16/4/437/1172282

28. Ranker LR, Wu J, Hong T, Wijaya D, Benjamin EJ, et al. Social media use, brand engagement, and tobacco product initiation among youth: Evidence from a prospective cohort study. Addictive Behaviors, 2024; 154:108000. Available from: https://www.ncbi.nlm.nih.gov/pubmed/38461745

29. Donaldson SI, Dormanesh A, Perez C, Majmundar A, and Allem JP. Association Between Exposure to Tobacco Content on Social Media and Tobacco Use: A Systematic Review and Meta-analysis. JAMA Pediatr, 2022. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35816331

30. Rutherford BN, Lim CCW, Cheng B, Sun T, Vu GT, et al. Viral Vaping: A systematic review and meta analysis of e-cigarette and Tobacco-Related social media content and its influence on youth behaviours and attitudes. Addictive Behaviors, 2023; 147:107828. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37591107

31. Landman A, Ling PM, and Glantz SA. Tobacco industry youth smoking prevention programs: protecting the industry and hurting tobacco control. American Journal of Public Health, 2002; 92(6):917-30. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12036777

32. Wakefield M, Flay B, Nichter M, and Giovino G. Effects of anti-smoking advertising on youth smoking:  a review. Journal of Health Communication, 2003; 8:229–47. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12857653

33. Wakefield M, Terry-McElrath Y, Emery S, Saffer H, Chaloupka FJ, et al. Effect of televised, tobacco company-funded smoking prevention advertising on youth smoking-related beliefs, intentions, and behavior. American Journal of Public Health, 2006; 96(12):2154-60. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17077405

34. Farrelly MC, Healton CG, Davis KC, Messeri P, Hersey JC, et al. Getting to the truth: evaluating national tobacco countermarketing campaigns. American Journal of Public Health, 2002; 92(6):901-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12036775

35. Henriksen L, Dauphinee AL, Wang Y, and Fortmann SP. Industry sponsored anti-smoking ads and adolescent reactance: test of a boomerang effect. Tobacco Control, 2006; 15(1):13-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16436398