Marketing works: Promote smoking and people smoke

Washington -- Many reports take on scientific questions and conclude more research is needed -- but not this one. A definitive government document makes its message clear: The marketing of tobacco products leads to increased tobacco use, and depictions of smoking in movies cause young viewers to try it themselves.

"The Role of the Media in Promoting and Reducing Tobacco Use," released Aug. 21 by the National Cancer Institute, was hailed by representatives of a host of anti-smoking groups as the most comprehensive analysis to date on how the media -- whether it's television, newspapers, radio, movies or billboards -- can encourage or discourage tobacco use.

The findings provide a clear direction for policymakers' efforts to curb smoking, said leaders of the AMA, the American Public Health Assn., the Campaign for Tobacco-Free Kids, the Centers for Disease Control and Prevention, and the American Legacy Foundation. They spoke at a Washington, D.C., briefing.

In developing the nearly 700-page volume, the authors drew on studies and consulted experts, said AMA Immediate Past President Ron Davis, MD, its senior scientific editor. He compared the report's scientific rigor with that of a U.S. surgeon general's report. Dr. Davis also is the director of the Center for Health Promotion and Disease Prevention at the Henry Ford Health System in Detroit

"It's the first government report to present definitive conclusions that tobacco advertising and promotion are causally related to the increased use of tobacco and that exposure to the depictions of smoking in the movies is causally related to youth smoking," said Dr. Davis.

Smoking continues to be the single largest cause of preventable deaths in the U.S., according to the CDC. Despite a roughly 50% decline in adult smoking over the past 40 years, about one in five Americans continues to smoke, and more than 4,000 young people smoke their first cigarette each day, according to the report.

The authors of the monograph, which is the 19th in an NCI series on tobacco control, believe they've hit upon the reason for smoking's lingering presence: the billions of dollars tobacco companies spend marketing their products.

These funds have grown tremendously over the decades, leaping from $1.8 million in 1975 to $13.5 billion in 2005, said Dr. Davis. The firms also have shifted marketing strategy from using the largest proportion of funds on print ads to promotions such as coupons for cigarettes, free samples and sporting event sponsorships.

Young people also are influenced by smoking in movies. "The depiction of smoking occurs in three-quarters of box-office hits," said Melanie Wakefield, PhD, also a senior scientific editor of the report and the director of the Centre for Behavioural Research in Cancer at the Cancer Council Victoria in Melbourne, Australia.

Studies reviewed for the report demonstrated a clear link between smoking on the screen and an increase in smoking by young teens, said Wakefield.

However, on the flip side, the power of the media also can be harnessed to dissuade young people from smoking and convince veteran smokers to quit, said Wakefield. The effect of such campaigns are greatest when combined with school- and community-based programs, she added.

In addition, research shows that ads carrying a strong negative message and stirring emotions such as sadness, regret, anger or disgust are more effective than ads using humor to communicate their message.

This guidance will be used in developing new anti-smoking campaigns, said Janet Collins, PhD, director of the CDC's National Center for Chronic Disease Prevention and Health Promotion. She acknowledged that the susceptibility of adolescents to tobacco advertising means that the agency will face an uphill battle.

Cheryl Healton, DrPH, American Legacy Foundation president and CEO, noted the battle between public health and the tobacco companies is a David-versus-Goliath struggle. "Even though nicotine is well-known to be the most addictive drug on the planet, the tobacco industry is spending $37 million a day to market their deadly products to consumers."

The monograph sends a strong message to state and federal legislators to aid in the fight, said William Corr, executive director of the Campaign for Tobacco-Free Kids. "We need less tobacco company marketing and more anti-tobacco marketing."

States receive more than $25 billion each year from 1998 tobacco settlement funds and cigarette taxes, but only three states spend what the CDC recommends on anti-tobacco measures, said Corr.