Last updated: May 2020
Suggested citation: Wood, L, Letcher, T, Winstanley, M & Hanley-Jones, S. 5.15 Tobacco advertising and promotion targeted at young people. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2020. Available from: https://www.tobaccoinaustralia.org.au/chapter-5-uptake/5-15-tobacco-advertising-and-promotion-targeted-at
For more detailed discussion concerning the influence of tobacco advertising on children and teenagers, and the effects of advertising bans, refer to Chapter 11, Tobacco advertising and promotion.
Since about 60% of Australians who have ever smoked have quit,1, 2 and since about half of all regular tobacco users who smoke long-term die prematurely,3 (with two-thirds of deaths among middle-aged smokers attributable to their smoking),4 the tobacco industry will not remain viable unless it recruits new smokers. In the US, the Centers for Disease Control estimated that in the late 1990s, a typical teenager would have been exposed to almost $20 billion worth of advertising promoting tobacco products.5 The study, published in 1999, found that children bought the most heavily advertised tobacco brands and were estimated to be three times more affected by advertising expenditures than adults.5
Major scientific reviews of decades of published research have concluded that tobacco advertising and promotion have directly influenced the uptake of smoking by young people.6-10
One systematic review examined articles quantitatively assessing the relationship between media exposure and substance use behaviour (including tobacco, alcohol and illicit drug use) among children and adolescents from 1980 to January 2008. ‘Media’ covered television, cinema, the Internet, electronic/video games, magazines and music (advertising was excluded). The review identified 42 studies, most based on television or film media, including 24 which examined tobacco use. The majority (88%) of the 24 studies (including 10 longitudinal studies) examining tobacco use reported a statistically significant relationship between increased media exposure and an increase in child and adolescent smoking behaviour (typically ever having tried smoking or age of uptake). Reviewers noted that the evidence supporting the relationship between media and tobacco use was stronger than that for alcohol and illicit drug use.11
In a major review drawing on research published between 1966 and 2005, Di Franza and colleagues concluded that the evidence satisfies all six standard statistical criteria for determining that there is a causal relationship between exposure to tobacco advertising and the uptake of smoking in children.12 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.
Tobacco advertising has been shown to influence youth smoking uptake and prevalence and banning or restricting tobacco advertising and marketing has been shown to reduce youth smoking. 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 2005.13 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.13
Most forms of tobacco advertising and promotion in Australian states and territories have been incrementally banned since 1973 by federal and state legislation. Over this period, tobacco manufacturers have adapted to restrictions by increasing activity in those areas where promotion was still allowed to occur, most notably during the early 2000s at retail outlets, through events promotions and via upgraded products and packaging. The Internet has also become an important conduit for pro-tobacco messages.14-16 The following sub-sections provide brief discussion about these kinds of promotions; for more detail, refer to Chapter 11. Further discussion about smoking imagery in movies, television shows and other popular media (including the Internet) can be found in Section 5.16, and tobacco-control responses to addressing these, in Section 5.29.
5.15.1 Point-of-sale displays
Cigarettes are the most widely available of all consumer products in Australia, including milk and bread.17
It is evident that the tobacco industry responded to restrictions on advertising at point of sale and elsewhere by attempting to maximise visual impact of products on display.18 Tobacco ‘powerwalls’, common in the early 2000s, were typically eye-catching and brightly lit, forming bold blocks of colour. Australian tobacco companies actively engaged in ensuring that their products received prominence in the retail setting by offering financial and other incentives to retailers.19 (see also Chapter 10, Section 10.5.4.1.1)
While point-of-sale displays may have been intended to encourage existing smokers to select different brands, it is also likely that such displays provided reassurance to current smokers and attracted the attention of potential new young smokers, who are frequent visitors to supermarkets, milk bars and other convenience stores.18 Australian evidence shows that such displays served as a cue to buy tobacco products and appeared to undermine attempts to quit smoking.20 Australian research has also found that point-of-sale display advertising may have increased the perception among schoolchildren that cigarettes were easy to obtain, and also influenced students’ recall of particular brands.21 In contrast, the vast majority of adult smokers do not appear to make their brand selection at the point of sale.22
Exposure to point-of-sale retail tobacco advertising and promotion significantly increases the odds of smoking initiation among young people.6, 23, 24 Several systematic reviews on promotion of tobacco products at point of sale and young people have found significant associations between exposure to point-of-sale tobacco promotions and smoking initiation, susceptibility to smoking, beliefs about the ease of obtaining tobacco and increased perceptions of smoking prevalence among young people’s peers.6, 25, 26
A 2016 meta-analysis found the odds of having tried smoking were about 1.6 times higher for children and young people who were frequently exposed to point-of-sale tobacco promotion, compared with those who were less frequently exposed. Moreover, the odds of being susceptible to future smoking among never-smokers were approximately 1.3 times higher for children and young people frequently exposed to point-of-sale tobacco promotion, compared with those less frequently exposed.24
The display of tobacco products at point of sale was banned in Australian states and territories during the 2000s—see Section 11.4.
Over the course of the phasing in of the UK point-of-sale display ban, (2012–2015), researchers explored the impact of the ban before, during and after, on young never smokers.27 The study found both partial and full implementation of the display ban to be followed by a reduction in smoking susceptibility among adolescents. Post ban, researchers recorded a reduction in brand awareness, with most young never smokers after the ban perceiving tobacco to be unappealing and smoking unacceptable. Most young never smokers showed support for the ban.27 Similarly, research examining adolescents’ perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point of sale display bans in Scotland found significant declines in adolescents’ perceived access of tobacco as well as significant declines in positive smoking attitudes. However, there was no change in perceived positive smoking norms.28
5.15.2 Event marketing
In Australia29 and overseas,30, 31 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. Young adults are of key importance to the industry, providing a pool of experimenters and uncommitted smokers.
Harper and Martin identify several ways in which event marketing is strategically important to the tobacco industry:29
- such events promote brand loyalty
- they may tip the balance between being an experimenter and becoming an addict
- they provide a positive social context in which smoking can occur, serving to reinforce smoking as well as encourage new smokers
- co-sponsorship of events by other youth-oriented brands (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 colour way.29 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.29
A 2019 investigation by Robert Kozinets and the Campaign for Tobacco-Free Kids uncovered tobacco companies inviting young social media influencers to parties and events where they were offered cigarettes and encouraged to pose and take photos with floor designs strategically modelled off cigarette brand logos.32 Promotion in this way exploits social media’s organic reach by encouraging ‘influencers’ to share photos of themselves with their many online followers, targeting a new generation of unsuspecting young people who are often underage and unaware that what they are looking at is effectively a paid advertisement.32 Although exposure to promotions of this kind may centre around young adults in the first instance, their influence can also be expected to trickle down to younger adolescents and children, who are keen to emulate adult behaviour.
For further discussion of these kinds of promotional events, see Chapter 11, Section 11.7.
5.15.3 Internet promotions
The global and largely unregulated nature of the Internet provides vast opportunities for the promotion of tobacco use in general, as well as for specific tobacco products.
Since conventional media was deemed off-limits to tobacco companies, social media platforms such as Youtube, Twitter, Facebook and Instagram have become an enticing form of relativity unregulated new media teaming with a global audience of young people.
Online tobacco advertising was found to be commonly encountered by young Australians, with almost one-third of the young people surveyed in 2013 reporting having been exposed.33 Participants of the study who were most likely to have recalled seeing online tobacco advertisements were young (12–15 years old) and/or female. Young non-smokers were also more likely to remember seeing tobacco advertising and branding than were current smokers. Tobacco advertising exposure increased over the time of the study, from 21% in 2010 to 29% in 2013, with much of the increase being seen via social media, specifically Facebook. At the time of the study, Facebook prohibited advertisements that directly promoted the sale of tobacco products, however, it did not prohibit advertisements that promoted the use of tobacco products.33
In 2019, Facebook and Instagram unveiled a new policy restricting sales and limiting content related to alcohol and tobacco products, including e-cigarettes.34 The policy prohibited all private sales, trades, transfers as well as gifting of alcohol and tobacco products. Brands posting content related to the sale or transfer of these products were restricted to an audience of adults 18 years or older.34 Campaign for Tobacco-Free Kids however, released a statement calling the policy ‘inadequate’, and stressed the policy would be:
‘ineffective in prohibiting tobacco companies from using influencer marketing to promote their products to young people in the United States and around the world. This policy ignores the primary way tobacco companies are promoting their products on social media, which is through rampant influencer marketing’.35
A two-year investigation by the Campaign for Tobacco-Free Kids and Netnografica LLCSocial36 uncovered numerous instances where young social media influencers with a significant number of online followers were paid to post photos of their adventures and lifestyle featuring Marlboro, Lucky Strike and other cigarette brands. Training was provided on which cigarette brands to promote, when to post pictures for maximum exposure and how to take ‘natural photos’ so not look like staged advertisements. The influencers were instructed on what hashtags to use and were often encouraged to post in English, indicating the tobacco companies desire to target a global audience that included Western countries.
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.37 Online pro-smoking media and advertising has been found to increase smoking susceptibility and initiation among young people. A 2016 research study38 in the US found both expressing and/or receiving pro-smoking messages through online social media had significant associations with smoking attitudes as well as intentions to smoke 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 and higher smoking intentions.38
For current regulation of online tobacco promotions please refer to Chapter 11, Section 11.11.5.
5.15.4 Anti-smoking advertising by the tobacco industry
Youth smoking prevention activities have been adopted by the tobacco industry internationally, in response to criticism that the industry has an interest in and 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 have provided a useful public relations service for the tobacco industry, promoting a positive corporate image without threatening its livelihood by reducing intention to smoke.39, 40 Analysis of transcripts from US tobacco litigation cases between 1992 and 2002 reveals that while the industry has invested heavily in financing anti-tobacco advertising and other programs, there has only been weak associated industry 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 youth smoking.41 In fact, industry anti-tobacco advertising may have fostered a more positive attitude towards the tobacco companies among young people,42, 43 and may have influenced teenagers in their senior high school years to take up smoking.41 There is also evidence that youth smoking prevention initiatives have been used to bolster the defence strategies of the tobacco industry in the face of increasing tobacco litigation in the US.41 Industry anti-tobacco advertising campaigns are discussed in greater detail in Chapter 10, Section 10.13.3.
Relevant news and research
For recent news items and research on this topic, click here. ( Last updated October 2020)
1. Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey: Survey report. Drug statistics series no. 25, AIHW cat. no. PHE 145.Canberra: AIHW, 2011. Available from: http://www.aihw.gov.au/publication-detail/?id=32212254712&libID=32212254712&tab=2.
2. Australian Institute of Health and Welfare. National Drug Strategy Household Survey (ndshs) 2016 key findings data tables. Canberra: AIHW, 2017. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/data.
3. Doll R, Peto R, Boreham J, and Sutherland I. Mortality in relation to smoking: 50 years' observations on male british doctors. BMJ, 2004; 328(7455):1519. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15213107
4. Banks E, Joshy G, Weber MF, Liu B, Grenfell R, et al. Tobacco smoking and all-cause mortality in a large Australian cohort study: Findings from a mature epidemic with current low smoking prevalence. BMC Medicine, 2015; 13(1):38. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25857449
5. Eriksen MP. Social forces and tobacco in society. Nicotine and Tobacco Research, 1999; 1 Suppl 1(suppl.1):S79-80. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11072409
6. US Department of Health and Human Services. Preventing tobacco use among youth and young adults: A report of the Surgeon General. Atlanta, GA: 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, 2012. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/2012/.
7. US 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/.
8. 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: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003439/pdf_fs.html
9. 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://www.ncbi.nlm.nih.gov/pubmed/15251888
10. 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
11. Nunez-Smith M, Wolf E, Huang HM, Chen PG, Lee L, et al. Media exposure and tobacco, illicit drugs, and alcohol use among children and adolescents: A systematic review. Journal of Substance Abuse Treatment, 2010; 31(3):174-92. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20687006
12. 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
13. 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
14. 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
15. 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
16. 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
17. Ministerial Council on Drug Strategy and Department of Health and Ageing. National Tobacco Strategy 2004-2009. Canberra: Commonwealth of Australia, 2005. Available from: https://untobaccocontrol.org/impldb/wp-content/uploads/reports/Australia_annex7_national_tobacco_strategy2004_2009.pdf.
18. Pollay RW. More than meets the eye: On the importance of retail cigarette merchandising. Tobacco Control, 2007; 16(4):270-4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17652243
19. Carter SM. New frontier, new power: The retail environment in Australia's dark market. Tobacco Control, 2003; 12 Suppl 3(suppl. 3):iii95-101. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14645954
20. Wakefield M, Germain D, and Henriksen L. The effect of retail cigarette pack displays on impulse purchase. Addiction, 2008; 103(2):322-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18042190
21. Wakefield M, Germain D, Durkin S, and Henriksen L. An experimental study of effects on schoolchildren of exposure to point-of-sale cigarette advertising and pack displays. Health Education Research, 2006; 21(3):338-47. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16702196
22. Wakefield M and Germain D. Adult smokers' use of point-of-sale displays to select cigarette brands [letter]. Australia and New Zealand Journal of Public Health, 2006; 30:483-4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17073234
23. Henriksen L, Schleicher NC, Feighery EC, and Fortmann SP. A longitudinal study of exposure to retail cigarette advertising and smoking initiation. Pediatrics, 2010; 126(2):232-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20643725
24. Robertson L, Cameron C, McGee R, Marsh L, and Hoek J. Point-of-sale tobacco promotion and youth smoking: A meta-analysis. Tobacco Control, 2016; 25(e2):e83-e9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26728139
25. Robertson L, McGee R, Marsh L, and Hoek J. A systematic review on the impact of point-of-sale tobacco promotion on smoking. Nicotine and Tobacco Research, 2015; 17(1):2-17. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25173775
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27. Ford A, MacKintosh AM, Moodie C, Kuipers MAG, Hastings GB, et al. Impact of a ban on the open display of tobacco products in retail outlets on never smoking youth in the UK: Findings from a repeat cross-sectional survey before, during and after implementation. Tobacco Control, 2020; 29(3):282-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31088915
28. Kuipers MA, Best C, Wilson M, Currie D, Ozakinci G, et al. Adolescents' perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point-of-sale display ban in Scotland: Results from the display study. Tobacco Control, 2020; 29(3):348-56. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31053651
29. 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
30. 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
31. 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
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34. Azad A. Facebook and Instagram to restrict content related to alcohol, tobacco and e-cigarettes. CNN, 2019. Available from: https://edition.cnn.com/2019/07/24/health/facebook-instagram-alcohol-tobacco-bn/index.html
35. Myers M. New Facebook/Instagram policy on tobacco marketing turns blind eye to biggest problem: Influencer marketing. Campaign for Tobacco-Free Kids, 2019. Available from: https://www.tobaccofreekids.org/press-releases/2019_07_25_facebook
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43. 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